摘要
目的 探讨癫痫患儿血清中孕酮（Prog）、硫酸脱氢表雄酮（DHEAS）水平及抗癫痫药物对癫 患儿Prog和DHEAS水平的影响。方法 以175例未经治疗的癫痫患儿（癫痫组）与66例年龄相匹配的青春前期健康儿童（健康对照组）为研究对象，应用电化学发光免疫法测定其血清 Prog及 DHEAS水平，并分别对96例癫痫患儿单药服用奥卡西平（OXC，OXC治疗组）、拉莫三嗪（LTG，LTG 治疗组）、丙戊酸钠（VPA，VPA 治疗组）治疗4个月后进行对比，观察各治疗组性激素变化。结果 1.健康对照组与癫痫组儿童 Prog水平出生后随年龄下降，至9岁后又逐渐升高；癫痫组女童Prog水平明显低于同年龄段健康对照组（P 〈0.05）；癫痫组男童Prog水平在〉9～12岁年龄段明显低于健康对照组（P 〈0.05）。2.健康对照组与癫痫组女童 Log（DHEAS）在6岁前随年龄增长而降低，后又随年龄增长逐渐升高，2组同年龄段比较，6岁后癫痫组女童 Log（DHEAS）均低于健康对照组（P均〈0.05）。健康对照组男童 Log（DHEAS）在6岁前随年龄增长而降低，在6岁后随年龄增长而升高。癫痫组男童Log（DHEAS）随年龄增长逐渐升高，两两比较后一年龄组均高于前一年龄组（P均 〈0.05）。3.OXC治疗组和 LTG 治疗组女童治疗前后血清 Prog及 Log（DHEAS）比较差异均无统计学意义（P均〉0.05），而VPA治疗组治疗后Prog和Log（DHEAS）均明显低于治疗前（P均〈0.01）。VPA治疗组男童治疗后Log（DHEAS）明显低于治疗前（P 〈0.01），余治疗组治疗前后血清Prog及 Log（DHEAS）比较差异均无统计学意义（P均〉0.05）。结论 临床可根据 Prog、Log（DHEAS）变化早期预测癫痫女童生殖功能疾病并早期干预；癫痫可能对男童性激素水平的影响较小；癫痫可能改变男童 DHEAS的正常生理波动；临床可根据Prog、Log（DHEAS）水平变化调整用药方案。
Objective To detect the serum levels of progestrone （Prog） and dehydroepiandrosterone sulfate （DHEAS） , and to explore the effects of antiepileptie drugs （AEDs） on the levels of Prog and DHEAS in epileptic chil- dren. Methods A total of 175 cases of prepuberty epilepsy before treatment and 66 cases prepuberty healthy children in the same ages were selected as the objects,the serum Prog and Log（DHEAS） levels were detected by electrochem- iluminescence immunoassay. In the 175 patients, 96 patients received monotherapy with oxcarbazepine （OXC, OXC group） , lamotrigine （LTG, LTG group） and sodium valproie acid （VPA, VPA group） , and the changes of sex hormone were determined at 4 months after treatment. Results 1. The level of Prog in epileptic children decreased after birth and increased after 9 years old in healthy control group and epileptic children. The level of Prog was significantly lower in epileptic female children than that in healthy control group with the same age （ P 〈 0.05 ）. The level of Prog was sig- nificantly lower in epileptic male children aged from 9 to 12 years old than that in healthy control group （P 〈 0.05 ）. 2. The Log （DHEAS） in healthy control group and epileptic female children decreased with ages before 6 years ,and in- creased with ages after 6 years old. Compared with the same age group, Log （DHEAS） was lower in epileptic female children than that in healthy control group after 6 years old （ all P 〈 0.05 ）. The Log （DHEAS） in healthy male chil- dren decreased with ages before 6 years old, and increased with ages after 6 years old in healthy control group, while it increased with ages in epileptic male children. Each groups were higher than the previous group in multiple comparisons （ all P 〈 0.05）. 3. There were no significant differences in serum Prog and Log （DHEAS） in female children in both OXC group and LTG group after treatment in comparison with before treatment （ all P 〉 0.05 ）. And the serum Prog and Log
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第22期1732-1735,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
河南省科技医学攻关计划项目
关键词
癫痫
孕酮
硫酸脱氢表雄酮
儿童
Epilepsy
Progesterone
Dehydroepiandrosterone sulfate
Child
