Verrotti A, Domizio S, Angelozzi B, Sabatino G, Morgese G, Chiarelli F
Department of Pediatrics, University of Chieti, Italy.
J Paediatr Child Health. 1997 Jun;33(3):242-5. doi: 10.1111/j.1440-1754.1997.tb01588.x.
To assess the effect of long-term treatment of phenobarbital, carbamazepine and sodium valproate on serum lipids and lipoproteins in epileptic children.
One hundred and fourteen (55 male, 59 female) children and adolescents suffering from various types of epilepsy who received different antiepileptic drugs were studied. The patients were subdivided into three groups according to their therapy: (i) carbamazepine (35 patients); (ii) phenobarbital (34 patients); and (iii) sodium valproate (45 patients). One-hundred healthy sex- and age-matched children served as controls. Lipids and lipoprotein profile were evaluated before the beginning of the anticonvulsant therapy and after at least 2.5 years. In the patients receiving phenobarbital, we re-evaluated 12 children (seven male, five female) at the end of therapy.
The children receiving phenobarbital showed high levels of serum total cholesterol and low-density lipoprotein (LDL) cholesterol and low levels of triglycerides, while children treated with carbamazepine had high levels of total cholesterol, triglycerides, LDL and high-density lipoprotein (HDL) cholesterol. Children treated with valproate had low triglycerides and LDL cholesterol levels with high levels of HDL cholesterol. The patients treated with phenobarbital showed a normalization of all parameters after the end of therapy.
Anticonvulsant drugs significantly modify serum lipids and lipoproteins in epileptic children. The changes due to phenobarbital seem to be transient.
评估苯巴比妥、卡马西平和丙戊酸钠长期治疗对癫痫患儿血脂和脂蛋白的影响。
对114名（55名男性，59名女性）患有各种类型癫痫且接受不同抗癫痫药物治疗的儿童和青少年进行了研究。根据治疗方法将患者分为三组：（i）卡马西平组（35例患者）；（ii）苯巴比妥组（34例患者）；（iii）丙戊酸钠组（45例患者）。100名年龄和性别匹配的健康儿童作为对照。在抗惊厥治疗开始前和至少2.5年后评估血脂和脂蛋白谱。在接受苯巴比妥治疗的患者中，我们在治疗结束时对12名儿童（7名男性，5名女性）进行了重新评估。
接受苯巴比妥治疗的儿童血清总胆固醇和低密度脂蛋白（LDL）胆固醇水平较高，甘油三酯水平较低，而接受卡马西平治疗的儿童总胆固醇、甘油三酯、LDL和高密度脂蛋白（HDL）胆固醇水平较高。接受丙戊酸治疗的儿童甘油三酯和LDL胆固醇水平较低，HDL胆固醇水平较高。接受苯巴比妥治疗的患者在治疗结束后所有参数均恢复正常。
抗惊厥药物可显著改变癫痫患儿的血脂和脂蛋白。苯巴比妥引起的变化似乎是短暂的。
