几种抗癫痫药物对癫痫患儿身高、体重影响的评价

Muhammad Abdulgafoor Ahmed AlKataan, Abdullah Shakir Mahmood, Aseel S. Al Mallakhdeer
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摘要

生长是一个多因素过程,受遗传、营养、荷尔蒙、社会心理和其他因素的影响,包括儿童的一般健康状况。癫痫被定义为一种慢性疾病,其特征是在没有代谢性或毒性疾病的情况下发生反复的临床事件或癫痫发作,用于治疗这种疾病的药物可因其作用机制而影响患者的生长。本研究旨在评价一些抗癫痫药物对癫痫患儿生长(身高和体重)的影响。这项工作涉及51名新诊断患有不同形式癫痫的儿童(全身性、缺席性和部分性)。根据治疗情况将患者分为三组(第一组患者单药卡马西平平均剂量13.3±4.8 mg/Kg,第二组患者单药丙戊酸平均剂量14.4±3.3 mg/Kg,最后一组患者联合卡马西平10.8±5.8加丙戊酸19.7±8.8)。患者年龄在5-11岁之间,初始BMI范围为12-20。本研究结果显示,卡马西平单药治疗对治疗6个月和12个月的BMI值均无显著影响(p>0.05)。丙戊酸单药组治疗6个月和12个月后BMI明显升高(p>0.01)。联合治疗对BMI无显著影响。丙戊酸治疗6个月和12个月后患者百分位高度显著升高(p0.05)。综上所述,使用抗癫痫药物的癫痫患儿需要严格的生长监测政策,特别是使用丙戊酸的癫痫患儿。
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Evaluation of the Detrimental Effects of some Antiepileptic Drugs on the Height and Weight of Children with Epilepsy
Growth is a multifactorial process influenced by genetic, nutritional, hormonal, psychosocial and other factors including the general health of a child. Epilepsy defined as a chronic condition characterized by recurrent clinical events or epileptic seizures, which occur in the absence of a metabolic or toxic disease the drugs that use in the treatment of this condition can affect patients growth due to their mechanisms of action. This study aimed to evaluate the effect of some antiepileptic drugs on growth (height and weight) in children with epilepsy. This work involved 51 newly diagnosed children with a different form of epilepsy (Generalized, absent and partial). Patients divided into three groups according to the treatment (group one patients on Carbamazepine monotherapy with dose mean 13.3 ± 4.8 mg/Kg, group two patients on Valproic acid monotherapy with a dose of 14.4± 3.3 mg/kg and the last group involve patient on combined therapy Carbamazepine 10.8±5.8 plus 19.7± 8.8 of Valproic acid. Patients age range from 5-11 years, with an Initial BMI range of 12-20. The results of this work showed that Carbamazepine monotherapy caused no significant affected on both BMI values after 6 and 12 months of treatment (p>0.05). Valproic acid monotherapy significantly elevated BMI after 6 and 12 months of treatment (p>0.01). Combined therapy showed no significate effect on BMI. The patient’s centile height significantly elevated after 6 and 12 months of Valproic acid (p<0.01) compared to the normal growth according to the growth chart. While both Carbamazepine and combined therapy showed no significant change in comparison to the normal growth according to the growth chart (p>0.05). In conclusion, children with epilepsy who use antiepileptic drugs need restricted monitor policy for their growth, especially those on Valproic acid.
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