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目的探讨丙戊酸治疗对癫癎患儿血浆胰岛素和瘦素水平的影响。方法测定2003-04—2004-02在山东大学齐鲁医院儿科癫癎治疗中心就诊且服用丙戊酸的32例癫癎患儿和33例对照组(儿外患儿)血浆胰岛素、瘦素水平并计算胰岛素抵抗值、体重指数,并对服用丙戊酸的癫癎患儿胰岛素抵抗值、瘦素与丙戊酸的剂量、疗程、体重指数进行相关分析。结果丙戊酸治疗组体重指数、胰岛素、胰岛素抵抗值、瘦素水平高于对照组;胰岛素抵抗值、瘦素水平与体重指数、丙戊酸疗程显著正相关,与剂量无相关性;偏相关分析示对照组胰岛素、胰岛素抵抗值与瘦素显著负相关,而丙戊酸治疗组胰岛素、胰岛素抵抗值与瘦素显著正相关。结论丙戊酸治疗可引起肥胖程度增加、胰岛素抵抗及瘦素抵抗;胰岛素抵抗、瘦素抵抗与肥胖程度增加有关,与丙戊酸疗程正相关;胰岛素抵抗与瘦素水平显著正相关。

Effects of valproate treatment on plasma levels of insulin and leptin in epilepsy children

Objective To investigate the effects of valproate treatment on plasma insulin and leptin levels of epileptic children.Methods Plasma insulin and leptin levels were measured in a group of 32 epileptic children treated with valproate and 33 age-matched children as control group,and insulin resistance(Homa IR) and body mass index were calculated.The associations between insulin resistance,leptin levels and dosage of valproate,duration of valproate therapy,body mass index were analyzed.Results Body mass index,insulin,insulin resistance and leptin levels were significantly higher in the valproate-treated group than those in the control group.In valproate-treated group,insulin resistance and leptin levels were positively correlated with body mass index and duration of valproate therapy,but exhibited no correlations with dosage of valproate.Partial correlation analysis revealed significant negative correlations between leptin levels and insulin resistance in control group,but significant positive correlations in valproate-treated group.Conclusion Valproate therapy can lead to weight gain,insulin resistance and leptin resistance.Insulin resistance and leptin levels are positively correlated with body mass index and duration of valproate therapy.There were positive correlations between insulin resistance and leptin levels.