Yeo P P, Bates D, Howe J G, Ratcliffe W A, Schardt C W, Heath A, Evered D C
Br Med J. 1978 Jun 17;1(6127):1581-3. doi: 10.1136/bmj.1.6127.1581.
Serum total and free thyroid hormone concentrations were estimated in 42 patients with epilepsy taking anticonvulsants (phenytoin, phenobarbitone, and carbamazepine either singly or in combination). There was a significant reduction in total thyroxine (TT4), free thyroxine (FT4), and free triiodothyronine (FT3) in the treated group compared with controls. Free hormone concentrations were lower than total hormone concentrations, suggesting that increased clearance of thyroid hormones occurs in patients receiving anticonvulsants. Detailed analysis indicated that phenytoin had a significant depressant effect on TT4, FT4, FT3, and reverse T3 (rT3). Phenobarbitone and carbamazepine had no significant main effects, but there were significant interactions between phenytoin and carbamazepine for TT4 and FT4. phenobarbitone and carbamazepine for FT3, and phenytoin and phenobarbitone for rT3.
对42例服用抗惊厥药（单独或联合使用苯妥英、苯巴比妥和卡马西平）的癫痫患者的血清总甲状腺激素和游离甲状腺激素浓度进行了评估。与对照组相比，治疗组的总甲状腺素（TT4）、游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）显著降低。游离激素浓度低于总激素浓度，这表明接受抗惊厥药治疗的患者甲状腺激素清除增加。详细分析表明，苯妥英对TT4、FT4、FT3和反三碘甲状腺原氨酸（rT3）有显著的抑制作用。苯巴比妥和卡马西平没有显著的主要作用，但苯妥英和卡马西平对TT4和FT4、苯巴比妥和卡马西平对FT3、苯妥英和苯巴比妥对rT3之间存在显著的相互作用。
