苯巴比妥、苯妥英、卡马西平对癫痫患儿甲状腺激素的影响

观察常用抗癫痫药物对癫痫患儿血清甲状腺激素的影响。对无甲状腺功能减退临床表现的癫痫患儿(各组均20例)共80例,应用RIA法测定血清TT4、TT3、FT4、FT3、rT3、TSH浓度。结果未经治疗癫痫患儿所有激素水平与正常对照组比较无显著差异,苯巴比妥组FT4值低于正常对照组(P<0.01),卡马西平组TT4、FT4值也明显降低(P<0.01),苯妥英组TT4、FT4、FT3值均显著降低(P<0.01),所有各组rT3、TSH无改变。资料表明,抗癫痫药物对甲状腺激素影响强度依次为苯妥英钠、卡马西平、苯巴比妥。

The effect of phenobarbital, diphenylhydantoin and carbamazepine on serum thyroid hormone levels in children with epilepsy

To observe the influence of different anti-epileptic drugs on serum thyroid hormone levels in children with epilepsy, the authors have adopted RIA technique to determine serum concentrations of TT4.TT3, FT4. FT3, rT3 and TSH in the total of 80 children with no clinical manifestations of hypothyroidism (as normal control group) and children with epilepsy (20 cases as each subgroup for observation separately). Through the clinical analysis, it was clearly demonstrated that all serum values of thyroid hormones in untreated children with epilepsy showed no evident difference as compared with normal control group. Meanwhile, only serum FT4 level in phenobarbital subgroup and serum TT4, FT4 levels in carba-mazepine subgroup were found to be significantly lower than normal control children (all P<0. 01). Moreover, serum FT4, TT4 and TT3 levels in diphenylhydantoin subgroup were more significantly reduced than those in normal control (P<0. 01). However, serum rT3 and TSH values in each subgroup showed no change at all. All the data mentioned above showed that the sequence of the intensity of influencing thyroid hormones by anti-epileptic drugs could be diphenylhydantoin, carba-mazepine and phenobarbital inorder.