中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
29期
2065-2067
,共3页
癫痫%丙戊酸镁%内分泌%生殖%激素
癲癇%丙戊痠鎂%內分泌%生殖%激素
전간%병무산미%내분비%생식%격소
Epilepsy%Magnesium valproate%Incretion%Reproduction%Hormone
目的 了解丙戊酸对女性癫痫患者生殖内分泌的影响.方法 选择2009年7月至2010年3月在河南省人民医院和郑州大学第一附属医院癫痫中心确诊为癫痫,并单独服用丙戊酸镁缓释片治疗的青春和育龄期女性癫痫患者30例.分别检测服药前、服药后3、6、12个月时卵泡刺激激素(FSH)、黄体生成素(LH)、催乳素(PRL)、雌二醇(E2)、孕酮(P)、睾酮(T)水平,观察月经及卵巢功能变化.结果 30例服用丙戊酸镁的女性癫痫患者治疗3、6、12个月的黄体生成素、卵泡刺激素水平与治疗前相比差异无统计学意义;服药3、6个月催乳素水平较服药前显著下降(P值分别为0.010,0.014);服药3、6、12个月的雌二醇水平与服药前相比持续性降低(P值分别为0.005,0.037,0.035);服药3个月的孕酮水平较服药前显著下降(P值为0.009);服药3、6、12个月睾酮水平与服药前相比持续性升高(P值分别为0.036,0.002,0.006).6例患者有(6/30,20%)月经异常;3例(3/30,10%)有多囊卵巢.结论 服用丙戊酸镁可引起女性癫痫患者生殖内分泌激素变化并引起月经改变、多囊卵巢等内分泌紊乱,随着服药时间延长,可能发生多囊卵巢综合征(PCOS).
目的 瞭解丙戊痠對女性癲癇患者生殖內分泌的影響.方法 選擇2009年7月至2010年3月在河南省人民醫院和鄭州大學第一附屬醫院癲癇中心確診為癲癇,併單獨服用丙戊痠鎂緩釋片治療的青春和育齡期女性癲癇患者30例.分彆檢測服藥前、服藥後3、6、12箇月時卵泡刺激激素(FSH)、黃體生成素(LH)、催乳素(PRL)、雌二醇(E2)、孕酮(P)、睪酮(T)水平,觀察月經及卵巢功能變化.結果 30例服用丙戊痠鎂的女性癲癇患者治療3、6、12箇月的黃體生成素、卵泡刺激素水平與治療前相比差異無統計學意義;服藥3、6箇月催乳素水平較服藥前顯著下降(P值分彆為0.010,0.014);服藥3、6、12箇月的雌二醇水平與服藥前相比持續性降低(P值分彆為0.005,0.037,0.035);服藥3箇月的孕酮水平較服藥前顯著下降(P值為0.009);服藥3、6、12箇月睪酮水平與服藥前相比持續性升高(P值分彆為0.036,0.002,0.006).6例患者有(6/30,20%)月經異常;3例(3/30,10%)有多囊卵巢.結論 服用丙戊痠鎂可引起女性癲癇患者生殖內分泌激素變化併引起月經改變、多囊卵巢等內分泌紊亂,隨著服藥時間延長,可能髮生多囊卵巢綜閤徵(PCOS).
목적 료해병무산대녀성전간환자생식내분비적영향.방법 선택2009년7월지2010년3월재하남성인민의원화정주대학제일부속의원전간중심학진위전간,병단독복용병무산미완석편치료적청춘화육령기녀성전간환자30례.분별검측복약전、복약후3、6、12개월시란포자격격소(FSH)、황체생성소(LH)、최유소(PRL)、자이순(E2)、잉동(P)、고동(T)수평,관찰월경급란소공능변화.결과 30례복용병무산미적녀성전간환자치료3、6、12개월적황체생성소、란포자격소수평여치료전상비차이무통계학의의;복약3、6개월최유소수평교복약전현저하강(P치분별위0.010,0.014);복약3、6、12개월적자이순수평여복약전상비지속성강저(P치분별위0.005,0.037,0.035);복약3개월적잉동수평교복약전현저하강(P치위0.009);복약3、6、12개월고동수평여복약전상비지속성승고(P치분별위0.036,0.002,0.006).6례환자유(6/30,20%)월경이상;3례(3/30,10%)유다낭란소.결론 복용병무산미가인기녀성전간환자생식내분비격소변화병인기월경개변、다낭란소등내분비문란,수착복약시간연장,가능발생다낭란소종합정(PCOS).
Objective To explore the effects of valproate (VPA) on endocrine system in adolescent and reproductive female patients with epilepsy. Methods A total of 30 adolescent and reproductive female patients with a diagnosis of epilepsy at our hospital during July 2009 to March 2010 were recruited. All cases with magnesium VPA alone were included. The levels of follicle-stimulating hormone ( FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), progesterone (P) and tesosterone (T) were detected respectively at pre-therapy and 3, 6 and 12 months post-therapy. And the changes of menstruation and ovaries were recorded. Results The serum concentration of PRL was lower at 3 and 6 months post-therapy than that at pre-therapy. There was significant difference (P = 0. 010 and 0.014 ) . The serum concentration of E2 significantly decreased after a 3-month therapy of valproate ( P ＜ 0. 05 ). While comparing the parameter's level between the initial test and at a 3, 6 and 12-month follow-up, the level of P significantly decreased in the later groups than that of the former one while the level of T showed a marked increase. The levels of FSH and LH were not significantly different at pre- and post-therapy. And 6 ( 20% ) of them presented with menstrual dysfunctions and 3 ( 10% ) polyeystic ovary. Conclusion The valproate therapy can not only cause the changes of endocrine system and hormonal levels, but also induce such endocrine dysfunction syndromes as menstrual suspension and polycystic ovary. It eventually causes polycystic ovary syndrome.
