Nakken K O, Kornstad S
The National Center for Epilepsy, Sandvika, Norway.
Epilepsia. 1998 Mar;39(3):326-30. doi: 10.1111/j.1528-1157.1998.tb01381.x.
It has been claimed that long-term use of antiepileptic drugs (AEDs) brings about changes in the lipid profile which might resist development of cardiovascular disease. The aim of this study was to test the following hypothesis: Do males with chronic epilepsy and on long-term treatment with AEDs have a lower than expected risk of developing coronary heart disease?
The coronary risk profile in 40 male patients with chronic epilepsy, aged 30-50 years, was explored, using an American individual coronary risk factor test program (the Cooper test). We made a survey of the patients' risk factors: total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, glucose, blood pressure, body fat percentage, physical fitness, hereditary factors, smoking habits, and degree of stress. Each factor was given a score, and the sum of scores constituted the total coronary risk profile. Eighty men in the same age group, casually selected from an industrial medical service, served as controls.
There was no statistically significant difference in the total coronary risk profile between the epilepsy patients and the controls. Nor were there any significant differences among the individual risk factors except for physical fitness level, which was significantly lower among the epilepsy group than among the controls. In the epilepsy group, however, there was a trend toward higher levels of total cholesterol, higher levels of HDL-cholesterol, lower levels of total cholesterol/HDL-cholesterol ratio, increased body fat percentage, greater heredity and somewhat greater coronary risk score as compared with the healthy controls, but the differences did not reach statistical significance. The protective effect against coronary heart disease exercised by the enzyme-inducing AEDs seems to be counteracted by other factors, like reduced physical fitness and increased body fat percentage.
Our hypothesis was not confirmed, because we found that the 40 patients with chronic epilepsy tested had about the same risk of developing coronary heart disease as did the control group.
据称，长期使用抗癫痫药物（AEDs）会导致血脂变化，这可能有助于预防心血管疾病的发生。本研究的目的是验证以下假设：患有慢性癫痫且长期接受AEDs治疗的男性患冠心病的风险是否低于预期？
采用美国个体冠心病风险因素测试程序（库珀测试），对40名年龄在30至50岁之间的慢性癫痫男性患者的冠心病风险状况进行了探究。我们对患者的风险因素进行了调查：总胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、血糖、血压、体脂百分比、身体素质、遗传因素、吸烟习惯和压力程度。每个因素都给出一个分数，分数总和构成总的冠心病风险状况。从工业医疗服务机构中随机选取80名同年龄组男性作为对照。
癫痫患者和对照组在总的冠心病风险状况方面没有统计学上的显著差异。除身体素质水平外，个体风险因素之间也没有显著差异，癫痫组的身体素质水平显著低于对照组。然而，与健康对照组相比，癫痫组存在总胆固醇水平较高、HDL胆固醇水平较高、总胆固醇/HDL胆固醇比值较低、体脂百分比增加、遗传因素较大以及冠心病风险评分略高的趋势，但差异未达到统计学意义。酶诱导型AEDs对冠心病的保护作用似乎被其他因素抵消，如身体素质下降和体脂百分比增加。
我们的假设未得到证实，因为我们发现，所测试的40名慢性癫痫患者患冠心病的风险与对照组大致相同。
