接受抗癫痫药物治疗的癫痫儿童的尿N-乙酰-β-D-氨基葡萄糖苷酶
Urinary N-acetyl-beta-D-glucosaminidase in epileptic children treated with antiepileptic drugs.
作者信息
Csáthy L, Oláh A V, Clemens B, György I, Varga J
机构信息
Department of Paediatrics, County Teaching Hospital, H-4043 Debrecen, Bartók B 2-26, Hungary.
出版信息
Arch Dis Child. 2000 Nov;83(5):420-2. doi: 10.1136/adc.83.5.420.
AIM
To investigate the effect of prolonged use of antiepileptic drugs on renal function in children.
METHODS
Prospective study of 72 children (aged 3-18 years) with epilepsy, on either monotherapy (n = 44) or combined therapy (n = 28). The length of treatment varied from 1 to 13 years. Drugs used were valproic acid, carbamazepine, ethosuximide, clonazepam, clobazepam, and vigabatrin.
RESULTS
In 65 patients plasma concentrations of the drugs were in the therapeutic range. In the remaining seven, plasma concentrations were slightly high. In 33 patients urinary N-acetyl-beta-D-glucosaminidase (NAG) activity was raised. The incidence of pathological NAG indices was significantly higher in the combined therapy group than in the monotherapy group. There were also significant differences in the NAG indices of patients depending on the duration of therapy.
CONCLUSIONS
Results suggest that chronic use of some antiepileptic drugs-in spite of normal blood concentrations-may alter tubular function, and the dysfunction may result in clinical symptoms. Therefore, we recommend screening of tubular function in these patients.
目的
探讨长期使用抗癫痫药物对儿童肾功能的影响。
方法
对72例3至18岁癫痫患儿进行前瞻性研究，其中44例接受单一疗法，28例接受联合疗法。治疗时间从1年至13年不等。使用的药物有丙戊酸、卡马西平、乙琥胺、氯硝西泮、氯巴占和氨己烯酸。
结果
65例患者的药物血浆浓度在治疗范围内。其余7例血浆浓度略高。33例患者的尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）活性升高。联合治疗组病理性NAG指标的发生率显著高于单一治疗组。根据治疗持续时间不同，患者的NAG指标也存在显著差异。
结论
结果表明，长期使用某些抗癫痫药物——尽管血药浓度正常——可能会改变肾小管功能，且这种功能障碍可能导致临床症状。因此，我们建议对这些患者进行肾小管功能筛查。
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