服用抗癫痫药物患者的同型半胱氨酸浓度及蛋氨酸负荷量
Homocysteine concentrations and methionine loading in patients on antiepileptic drugs.
作者信息
Apeland T, Mansoor M A, Strandjord R E, Kristensen O
机构信息
Department of Internal Medicine, The Central Hospital of Rogaland, Stavanger, Norway.
出版信息
Acta Neurol Scand. 2000 Apr;101(4):217-23. doi: 10.1034/j.1600-0404.2000.101004217x./.
OBJECTIVES
A few reports have shown elevated fasting total plasma homocysteine (tHcy) in patients taking antiepileptic drugs (AEDs). In this study we determined the influence of AEDs on plasma tHcy levels prior to and following methionine loading.
MATERIAL AND METHODS
Thirty-four patients on different AEDs and 34 matched controls were recruited. Blood samples were drawn prior to and 6 h post-methionine loading (6h-PML).
RESULTS
The patients on AEDs inducing the cytochrome P450 (carbamazepine, phenytoin, phenobarbital, primidone), had higher fasting and 6h-PML plasma tHcy concentrations than the controls (P = 0.01 and P<0.001). Patients on AED inhibiting the cytochrome P450 (valproate [VPA]), had lower 6h-PML p-tHcy concentrations than controls (P = 0.01).
CONCLUSIONS
Our data indicate that not only fasting but also 6h-PML tHcy levels should be determined in order to identify hyperhomocysteinemia among patients on AEDs. Inducer AEDs seem to have an opposite effect than the inhibitor VPA on plasma tHcy, erythrocyte folate and serum folate levels.
目的
有几份报告显示服用抗癫痫药物（AEDs）的患者空腹血浆总同型半胱氨酸（tHcy）水平升高。在本研究中，我们测定了AEDs对蛋氨酸负荷前后血浆tHcy水平的影响。
材料与方法
招募了34名服用不同AEDs的患者和34名匹配的对照者。在蛋氨酸负荷前及负荷后6小时（6h-PML）采集血样。
结果
服用诱导细胞色素P450的AEDs（卡马西平、苯妥英、苯巴比妥、扑米酮）的患者，其空腹和6h-PML血浆tHcy浓度高于对照组（P = 0.01和P<0.001）。服用抑制细胞色素P450的AEDs（丙戊酸[VPA]）的患者，其6h-PML血浆tHcy浓度低于对照组（P = 0.01）。
结论
我们的数据表明，为了识别服用AEDs患者中的高同型半胱氨酸血症，不仅应测定空腹tHcy水平，还应测定6h-PML tHcy水平。诱导性AEDs对血浆tHcy、红细胞叶酸和血清叶酸水平的影响似乎与抑制性VPA相反。
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