抗癫痫药物对血中同型半胱氨酸、叶酸、维生素B12浓度的影响

目的：探讨抗癫痫药物(Antiepileptic Drugs, AEDs)对血同型半胱氨酸(Homocysteine, Hcy)、叶酸、维生素B12(VitaminB12，VitB12)浓度的影响。方法：采用荧光定量法和电化学发光免疫法测定88例服用单一药物治疗的癫痫患者（服用卡马西平、苯妥英钠各30例、服用丙戊酸28例）和30例未服用AEDs的癫痫对照者及40例健康对照者血Hcy、叶酸、VitB12浓度,比较各组间差异。结果：服用卡马西平和苯妥英钠的患者血Hcy水平明显高于癫痫对照组和正常对照组(P＜0.001),叶酸水平明显低于癫痫对照组和正常对照组(P＜0.001)，服用丙戊酸的患者血Hcy水平有下降趋势、叶酸水平有上升趋势，但与两对照组相比，差异无统计学意义。VitB12在癫痫组有下降趋势,但与两对照组相比，差异无统计学意义。结论：服用卡马西平、苯妥英钠的患者Hcy水平升高而叶酸水平降低，对这类癫痫患者适当补充叶酸、VitB12可能有益于降低心脑血管病的发病率。

Effect of anti-epileptic drugs on the blood levels of homocysteine, folate and vitaminB12

Objective: To investigate the effect of antiepileptic drugs(AEDs) on the blood levels of homocysteine, folate and vitaminB12. Methods: There were 3 groups tested: ①88 epipleptic patients, taking a single AEDs; ②epileptic control group, 30 epileptic patients not taking AEDs; ③normal control group, 40 healthy controls. The levels of homocysteine, folate and vitaminB12 were determined by a fluorescence quantity method and an electrochemistry radiation immunity. Results： In epileptic patients taking a single carbamazepine (CBZ) and phenytoin(PHT), the levels of homocysteine were significantly higher and the levels of folate were significantly lower than those of the control group(P＜0.001). The levels of homocysteine, folate and vitaminB12 were not significantly changed in patients taking valproic acid(VPA)(P＞0.05). Conclusions： Homocysteine levels of epileptic patients taking CBZ and PHT were significantly increased whereas the folate levels of epileptic patients taking CBZ and PHT were signifacantly decreased. An adequate dosage of folate and vitaminB12 for epileptic patients is helpful in preventing angiocardiopathy and cerebrovascular diseases.