Bachmann T, Bertheussen K H, Svalheim S, Rauchenzauner M, Luef G, Gjerstad L, Taubøll E
Department of Neurology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
Acta Neurol Scand Suppl. 2011(191):23-7. doi: 10.1111/j.1600-0404.2011.01539.x.
Little is known about the haematological side effects of the newer antiepileptic drugs (AEDs), but recent case reports have raised concerns regarding the possibility of altered thrombocyte counts or function in some patients during levetiracetam (LEV) treatment. The aim of our study was to investigate haematological changes in patients treated with the newer AEDs, LEV and lamotrigine (LTG), compared with the older AEDs, valproate (VPA) and carbamazepine (CBZ).
This cross-sectional study included 251 patients with epilepsy of both genders, aged 18-45 years, using AED monotherapy: 52 patients on LEV (31 men, 21 women), 80 on LTG (37 men, 43 women), 90 on CBZ (61 men, 29 women), 29 on VPA (15 men, 14 women), and 79 healthy controls (36 men, 43 women). Haemoglobin (Hb), white blood cells (WBC) and platelet (thrombocyte) counts were estimated. The subjects were recruited from hospitals in south-eastern Norway and Innsbruck, Austria.
Significantly lower platelet counts were recorded in both men and women on LEV monotherapy. In the LEV group, platelets were 14% lower (40.68 × 10(9) /l lower) than in the control group. There was no difference according to sex or age of the patients. Only minor changes in haematological parameters were observed for the other drugs investigated.
Both men and women treated with LEV monotherapy have lower blood platelet counts than healthy controls, with no difference in Hb or WBC. Haematological changes observed with the other AEDs were minor.
对于新型抗癫痫药物（AEDs）的血液学副作用知之甚少，但近期的病例报告引发了人们对于左乙拉西坦（LEV）治疗期间部分患者血小板计数或功能改变可能性的担忧。我们研究的目的是调查与传统AEDs丙戊酸盐（VPA）和卡马西平（CBZ）相比，使用新型AEDs左乙拉西坦（LEV）和拉莫三嗪（LTG）治疗的患者的血液学变化。
这项横断面研究纳入了251例年龄在18 - 45岁的癫痫患者，均采用AED单药治疗：52例使用LEV（男性31例，女性21例），80例使用LTG（男性37例，女性43例），90例使用CBZ（男性61例，女性29例），29例使用VPA（男性15例，女性14例），以及79名健康对照者（男性36例，女性43例）。对血红蛋白（Hb）、白细胞（WBC）和血小板计数进行了评估。研究对象来自挪威东南部和奥地利因斯布鲁克的医院。
接受LEV单药治疗的男性和女性血小板计数均显著降低。在LEV组中，血小板比对照组低14%（低40.68×10⁹ /L）。患者的性别和年龄对此并无差异。对于所研究的其他药物，仅观察到血液学参数的轻微变化。
接受LEV单药治疗的男性和女性血小板计数均低于健康对照者，而Hb或WBC无差异。使用其他AEDs观察到的血液学变化较小。
