Futagi Y, Otani K, Abe J
Division of Pediatric Neurology, Osaka Medical Center, Japan.
Pediatr Neurol. 1996 Nov;15(4):323-6. doi: 10.1016/s0887-8994(96)00228-7.
To clarify the effect of the clinical dosage of acetazolamide on growth in children with epilepsy or febrile convulsion, the standard scores of height and weight in 17 subjects receiving acetazolamide as an adjunct to unchanged monotherapy of antiepileptic drug were compared longitudinally through four phases: before antiepileptic drug administration, with monotherapy of antiepileptic drug, with acetazolamide in addition to monotherapy, and after acetazolamide discontinuation. The standard scores of both height and weight in the subjects were significantly reduced during the phase of acetazolamide administration. During this period, serum concentrations of potassium and total CO2 decreased while that of chloride increased, suggesting the existence of metabolic acidosis in the subjects. For both height and weight, there was no correlation between the degree of standard score reduction during acetazolamide administration and age at the time of acetazolamide initiation, duration of acetazolamide administration, dosages of acetazolamide, and variety of antiepileptic drugs concomitantly administered with acetazolamide. We speculate that metabolic acidosis induced by acetazolamide suppressed the growth of the subjects and that there were large individual differences in the susceptibility to acetazolamide for growth suppression among patients receiving acetazolamide.
为阐明乙酰唑胺临床剂量对癫痫或热性惊厥患儿生长发育的影响，对17例接受乙酰唑胺作为抗癫痫药物单一疗法辅助治疗的患儿，在四个阶段进行纵向比较：抗癫痫药物给药前、抗癫痫药物单一疗法治疗时、抗癫痫药物单一疗法加用乙酰唑胺时、停用乙酰唑胺后。在给予乙酰唑胺期间，患儿身高和体重的标准分数均显著降低。在此期间，血清钾浓度和总二氧化碳浓度降低，而氯浓度升高，提示患儿存在代谢性酸中毒。对于身高和体重，在给予乙酰唑胺期间标准分数降低的程度与开始使用乙酰唑胺时的年龄、乙酰唑胺给药持续时间、乙酰唑胺剂量以及与乙酰唑胺同时使用的抗癫痫药物种类之间均无相关性。我们推测，乙酰唑胺诱发的代谢性酸中毒抑制了患儿的生长，且在接受乙酰唑胺治疗的患者中，对乙酰唑胺生长抑制作用的易感性存在较大个体差异。
