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评估特发性耐药性癫痫儿童血清锌、铜、镁和 25-羟维生素 D 水平:一项横断面研究。

Evaluating the serum levels of zinc, copper, magnesium, and 25-hydroxy vitamin D in children with idiopathic drug-resistant epilepsy; a cross-sectional study.

机构信息

Pediatric Neurologist, Department of Pediatric Neurology, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.

Department of Pediatrics, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Pediatr. 2024 Aug 10;24(1):518. doi: 10.1186/s12887-024-04968-9.

Abstract

BACKGROUND

Drug-resistant epilepsy is defined as failure of seizure control in spite of using 2 or 3 proper antiepileptic drugs in appropriate time. Mineral elements play important roles in neuronal function; it is believed that mineral deficiency may lead to complications through seizure management. In the present study, serum levels of zinc (Zn), copper (Cu), magnesium (Mg), calcium (Ca), and 25-hydroxy vitamin D (Vit D) in drug-resistant-epilepsy (DRE) patients were evaluated and compared with the controlled patients.

METHODS

In this cross-sectional study, epileptic patients were included and categorized into two groups of DRE and well-controlled patients. Patients' serum samples were analysed to evaluate Zn, Cu, Mg, Ca, and Vit D levels. The primary objective was comparison of serum levels of different trace elements between the groups.

RESULTS

Sixty-four epileptic children including 33 DRE and 31 well-controlled children entered the study. The DRE children showed a significantly earlier onset of disease compared to the other group (p = 0.014). Comparing the frequency of developmental delay between the groups, the results showed this complication was significantly more frequent in the DRE group (p < 0.001). Concerning serum elements, the results showed a significantly higher concentration of Zn in the well-controlled group than the DRE group (p = 0.007). On the other hand, no significant differences were observed between the groups regarding the means of Vit D, Ca, Cu, and Mg levels (p > 0.05).

CONCLUSION

The results of the present study delineated that drug-resistant epilepsy patients had earlier onset of disease and were at higher risk of neurodevelopmental delay compared with well-controlled-epilepsy patients. A significant lower serum levels of Zn were also observed in drug-resistant-epilepsy patients. This finding may suggest the role of zinc supplementation in help to better control of drug-resistant seizures, as well as, the importance of serum zinc monitoring in epileptic patients.

摘要

背景

耐药性癫痫是指尽管在适当的时间内使用了 2 或 3 种适当的抗癫痫药物,但仍未能控制癫痫发作。矿物质元素在神经元功能中起着重要作用;人们相信矿物质缺乏可能会导致通过癫痫发作管理的并发症。在本研究中,评估了耐药性癫痫(DRE)患者与对照组患者的血清锌(Zn)、铜(Cu)、镁(Mg)、钙(Ca)和 25-羟维生素 D(Vit D)水平,并进行了比较。

方法

在这项横断面研究中,纳入了癫痫患者,并将其分为 DRE 组和控制良好的患者组。分析患者的血清样本以评估 Zn、Cu、Mg、Ca 和 Vit D 水平。主要目的是比较两组之间不同微量元素的血清水平。

结果

共有 64 名癫痫患儿入组,其中 33 名 DRE 患儿和 31 名控制良好的患儿。DRE 患儿的疾病发病年龄明显早于其他组(p=0.014)。比较两组之间发育迟缓的频率,结果显示 DRE 组的这种并发症明显更常见(p<0.001)。关于血清元素,结果显示对照组的 Zn 浓度明显高于 DRE 组(p=0.007)。另一方面,两组之间的 Vit D、Ca、Cu 和 Mg 水平的平均值无显著差异(p>0.05)。

结论

本研究结果表明,与控制良好的癫痫患者相比,耐药性癫痫患者的疾病发病年龄更早,发生神经发育迟缓的风险更高。耐药性癫痫患者的血清 Zn 水平也明显较低。这一发现可能表明锌补充剂在帮助更好地控制耐药性癫痫发作方面的作用,以及监测癫痫患者血清锌水平的重要性。

相似文献

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1
What Are the Functions of Zinc in the Nervous System?锌在神经系统中的功能有哪些?
Neurology. 2023 Oct 17;101(16):714-720. doi: 10.1212/WNL.0000000000207912.
2
Drug-resistant epilepsy: Definition, pathophysiology, and management.耐药性癫痫:定义、病理生理学和治疗。
J Neurol Sci. 2023 Sep 15;452:120766. doi: 10.1016/j.jns.2023.120766. Epub 2023 Aug 14.
3
Zinc and Central Nervous System Disorders.锌与中枢神经系统疾病。
Nutrients. 2023 Apr 29;15(9):2140. doi: 10.3390/nu15092140.
4
Drug resistance in epilepsy.癫痫的耐药性。
Lancet Neurol. 2023 Aug;22(8):723-734. doi: 10.1016/S1474-4422(23)00151-5. Epub 2023 Jun 20.
9
Clinical Management of Drug Resistant Epilepsy: A Review on Current Strategies.耐药性癫痫的临床管理:当前策略综述
Neuropsychiatr Dis Treat. 2021 Jul 12;17:2229-2242. doi: 10.2147/NDT.S256699. eCollection 2021.

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