Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Department of Pediatric Emergency, University of Health Science Kanuni Training and Research Hospital, Trabzon, Turkey.
Acta Neurol Belg. 2020 Jun;120(3):615-619. doi: 10.1007/s13760-018-0908-x. Epub 2018 Mar 5.
The aim of this study was to evaluate the thyroid function alterations in a group of epileptic children taking antiepileptic drugs. The study included a total of 183 pediatric epilepsy patients, aged 15 months-16 years, comprising 114 patients treated with valproic acid, 69 patients treated with phenobarbital, and 151 age-matched healthy volunteers as the control group. Serum levels of thyroid hormones were measured before the beginning of the antiepileptic therapy and after 12 months of treatment. Thyroid-stimulating hormone levels were significantly higher in the 12th month of phenobarbital and valproic acid treatment. The level of free triiodothyronine before treatment was higher in epileptic patients than in the control group. Subclinical hypothyroidism at month 12 was determined in 15.2% of the valproic acid group and in 2.9% of the phenobarbital group. When compared with the pre-treatment values, there was a statistically significant difference in the incidence of subclinical hypothyroid in the valproic acid group and no significant difference in the phenobarbital group. Symptomatic hypothyroidism was not detected. It was concluded that the thyroid functions of patients using valproic acid and phenobarbital for a long time should be regularly monitored.
本研究旨在评估一组服用抗癫痫药物的癫痫儿童的甲状腺功能变化。该研究共纳入 183 例 15 个月至 16 岁的儿科癫痫患者，其中 114 例接受丙戊酸钠治疗，69 例接受苯巴比妥治疗，151 例年龄匹配的健康志愿者作为对照组。在开始抗癫痫治疗前和治疗 12 个月后测量甲状腺激素水平。第 12 个月时，苯巴比妥和丙戊酸钠治疗组的促甲状腺激素水平显著升高。治疗前，癫痫患者的游离三碘甲状腺原氨酸水平高于对照组。第 12 个月时，丙戊酸钠组亚临床甲状腺功能减退的发生率为 15.2%，苯巴比妥组为 2.9%。与治疗前相比，丙戊酸钠组亚临床甲状腺功能减退的发生率有统计学意义，而苯巴比妥组无显著差异。未发现症状性甲状腺功能减退。结论：长期使用丙戊酸钠和苯巴比妥的患者，其甲状腺功能应定期监测。
