【摘要】 目的:研究服用托吡酯、丙戊酸的癫病人的体重变化是否与胰岛素和瘦素水平的变化有关。方法:用放射免疫方法检测142例癫病人的空腹胰岛素和瘦素水平。结果:①托吡酯组(55例)与对照组(35例)比:托吡酯组空腹胰岛素水平低于对照组(P=0·025),尤其是女性病人(P=0·040);两组空腹瘦素水平的差异无显著性(P=0·420),但男性的空腹瘦素水平均低于女性(对照组P=0·001,托吡酯组P=0·022)。②丙戊酸组(24例)与对照组(28例)比:两组空腹胰岛素水平的差异无显著性(P=0·368),但丙戊酸组肥胖病人的空腹胰岛素水平高于非肥胖病人(P=0·032);丙戊酸组空腹瘦素水平高于对照组(P=0·017),尤其是肥胖病人(P=0·011);丙戊酸组肥胖病人的空腹瘦素水平高于非肥胖病人(P=0·037)。结论:托吡酯可显著降低非肥胖女性癫病人的空腹胰岛素水平,对瘦素水平无显著性影响。丙戊酸对癫病人空腹胰岛素水平无明显影响;可显著增加癫病人的空腹瘦素水平,尤其是肥胖病人。更多还原

【Abstract】 Aim:To investigate whether changes of insulin and leptin levels play a role in the weight loss associated with topiramate and the weight gain associated with valproate acid in epileptic patients. Methods:142 epileptic patients were chosen ,55 cases of them received topiramate monotherapy and 35 cases did not,24 cases received valproate acid monotherapy and 28 cases as their control group.The fasting serum insulin and leptin levels were measured by radioimmunoassay(RIA). Results:①Topiramate and control group:The mean fasting serum insulin level of topiramate group was less than control group(P=0.025),especially to female patients (P=0.040); There was no statistical difference between the mean fasting serum leptin level of the two groups(P=0.42),but the mean fasting serum leptin level of male patients was less than that of female patients in the two groups (control group:P=0.001,topiramate group:P=0.022). ② Valproate acid and control group:There was no statistical difference between the mean fasting serum insulin level of the two groups(P=0.368),but in VPA group,the mean fasting serum insulin level of obese patients was higher than nonobese patients(P=0.032);The mean fasting serum leptin level of valproate acid group was higher than control group,especially to obese patients(P=0.011).The mean fasting serum leptin level of obese patients was higher than nonobese in valproate acid group(P=0.037).Conclusion:Topiramate reduced fasting serum insulin level of nonobese epileptic patients significantly,especially to female patients; Valproate acid had no influence on fasting serum insulin level of epileptic patients,but can increase their fasting serum leptin level,especially to obese epileptic patients.更多还原