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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。
Objective To investigate the effects of valproic acid treatment on plasma insulin and leptin in children with epilepsy. Methods 2003-04-2004-02 32 cases of epilepsy and 33 cases of children (children with extra-infantile epilepsy) were treated with valproic acid in pediatric epilepsy treatment center of Qilu Hospital of Shandong University and plasma insulin and leptin levels Insulin resistance and body mass index were calculated. Insulin resistance, leptin and valproic acid dose, duration of treatment and body mass index were analyzed in children with epilepsy. Results The body mass index, insulin, insulin resistance and leptin in valproic acid treatment group were higher than those in control group. Insulin resistance and leptin levels were positively correlated with body mass index and valproic acid course, but not with dose Analysis showed that the control group, insulin resistance and leptin significantly negatively correlated, while valproic acid treatment group insulin, insulin resistance and leptin significantly positively correlated. Conclusions Valproic acid treatment can cause obesity, insulin resistance and leptin resistance. Insulin resistance and leptin resistance are related to the increase of obesity, and are positively correlated with valproic acid therapy. Insulin resistance is positively correlated with leptin level.