摘要
①目的 探讨卡马西平(CBZ)、丙戊酸钠(VPA)对成年男性癫痫病人甲状腺激素水平的影响及其机制。②方法 选择新确诊的50例成年男性癫痫病人为治疗组(25 例服用卡马西平、25 例服用丙戊酸钠),测定用药前甲状腺激素水平并与30例健康对照组进行比较;卡马西平、丙戊酸钠分组单药治疗6 个月后检测血中甲状腺激素、γ谷氨酰转酞酶、甲状腺相关抗体水平的变化。③结果 未经治疗的癫痫病人甲状腺激素水平与正常对照组比较无显著差异(F=0.18 ~ 1.57, P> 0. 05);服用卡马西平治疗6 个月后T4、FT4、T3 和rT3 显著降低(t=-2.17~24.89,P<0.05),而FT3、TSH、TPOAb/TMAb、TG Ab和GGT无显著性变化(t=-1.56~1.68,P>0.05),T4、FT4、T3 或rT3 的降低与甲状腺相关抗体及GGT均无相关性(r=-0.006^-0.364,P>0.05);丙戊酸钠组治疗前后的甲状腺激素、促甲状腺激素、相关抗体水平及GGT均正常(t=-0.33~0.62,P>0.05)。④结论癫痫本身及丙戊酸钠治疗并不引起甲状腺激素的改变。卡马西平治疗的病人血清甲状腺激素水平下降,这种下降可能不是肝酶诱导机制或免疫激活所致,卡马西平有可能通过干扰下丘脑垂体对甲状腺激素的合成调节而影响甲状腺激素的水平。
Objective To evaluate the effects of carbamazepine(CBZ) and valproate(VPA) on the level of thyroid hormones in male patients with epilepsy, and the related mechanisms. Methods Serum thyroid hormone, gamma-glutamyl-transferase(GGT) and antibody (ab) concentrations in 50 epileptic patients(25 taking CBZ, 25 taking VPA monotherapy) were measured before the treatment with antiepileptic drugs, the results were compared with those of 30 healthy controls. The changes of thyroid hormone levels were observed six months after the treatment with CBZ or sodium VPA. The correlation between thyroid hormone and GGT or antithyroid antibody was studied. Results No significant difference existed in serum thyroid hormone, GGT or antithyroid antibody between the untreated patients and the controls (F=0.18-1.57,P>0.05). In men taking CBZ, serum thyroxine(T_4), free thyroxine(FT_4), rT_3,and T_3 were significantly lower after six months of the CBZ treatment(t=-2.17-24.89, P<0.05). Serum free tri-iodothyonine(FT_3) and thyrotropin(TSH), GGT, antibody in men taking CBZ were normal (t=-1.56- 1.68, P>0.05). There were no significant correlations between changes of thyroid hormones and the concentrations of GGT (r=-0.006--0.364,P>0.05). In men taking VPA, the concentrations of thyroid hormones, thyrotropin, GGT, and antithyroid antibody were normal (t=-0.33-0.62,P>0.05). Conclusion Epilepsy and VPA do not affect thyroid function. Serum thyroid hormone concentrations are low in CBZ-treated men, which might not be due to liver enzyme induction or activation of auto-immunologic mechanisms. CBZ may have effects on the function of the hypothalamo-pituitary axis.
出处
《齐鲁医学杂志》
2005年第1期42-45,共4页
Medical Journal of Qilu
