CAJ | 학술논문

目的探讨婴儿痉挛患儿血清中孕酮(progesterone,Prog)、硫酸脱氢表雄酮(dehydroepiandrosterone sulfate,DHEAS)水平及丙戊酸钠(sodium valproate,VPA)、拉莫三嗪(lamotrigine,LTG)对患儿Prog和DHEAS水平的影响.方法以36例未经治疗的婴儿痉挛患儿(病例组)与40例健康婴儿(对照组)为研究对象,应用电化学发光免疫法测定血清Prog及DHEAS水平,并分别对21例单药服用VPA(VPA治疗组)、13例添加LTG(LTG添加治疗组)治疗4个月前后对比,观察各治疗组女婴患儿和男婴患儿性激素的变化.结果病例组与对照组女婴患儿与男婴患儿血清Prog和log(DHEAS)(经对数转换)水平差异均无统计学意义(P均＞0.05).VPA治疗组治疗后女婴患儿和男婴患儿血清Prog水平均明显低于治疗前(t=2.603、3.146,P=0.003、0.008);LTG添加治疗组治疗后女婴患儿和男婴患儿血清log(DHEAS)水平均明显高于治疗前(t=3.185、2.663,P=0.007、0.041).结论婴儿痉挛可能并不影响患儿激素代谢,VPA、LTG可影响婴儿激素水平,在治疗期间应该监测患儿血清激素水平.
목적 탐토영인경련환인혈청중잉동(progesterone,Prog)、류산탈경표웅동(dehydroepiandrosterone sulfate,DHEAS)수평급병무산납(sodium valproate,VPA)、랍막삼진(lamotrigine,LTG)대환인Prog화DHEAS수평적영향.방법 이36례미경치료적영인경련환인(병례조)여40례건강영인(대조조)위연구대상,응용전화학발광면역법측정혈청Prog급DHEAS수평,병분별대21례단약복용VPA(VPA치료조)、13례첨가LTG(LTG첨가치료조)치료4개월전후대비,관찰각치료조녀영환인화남영환인성격소적변화.결과 병례조여대조조녀영환인여남영환인혈청Prog화log(DHEAS)(경대수전환)수평차이균무통계학의의(P균＞0.05).VPA치료조치료후녀영환인화남영환인혈청Prog수평균명현저우치료전(t=2.603、3.146,P=0.003、0.008);LTG첨가치료조치료후녀영환인화남영환인혈청log(DHEAS)수평균명현고우치료전(t=3.185、2.663,P=0.007、0.041).결론 영인경련가능병불영향환인격소대사,VPA、LTG가영향영인격소수평,재치료기간응해감측환인혈청격소수평.
Objective To explore the serum levels of progestrone (Prog) and dehydroepiandrosterone sulfate(DHEAS),and the effect of sodium valproate(VPA) and lamotrigine(LTG) on the levels of Prog and DHEAS in infantile spasms.Methods A total of 36 cases of infantile spasms (spasms group) before treatment and 40 cases health infants(control group) were detected the serum Prog and DHEAS levels by electrochemiluminescence immunoassay,and were compared with 21 cases receiving monotherapy with VPA(VPA group),and 13 cases receiving therapy plus lamotrigine(LTG group) before and 4 months after treatment to observe the changes of sex hormone.Results There were no significant differences in Prog and log(DHEAS) (logarithmic transformation) levels between spasms group and control group (P ＞0.05).The serum Prog level of baby girls and baby boys were lower after treatment than those before treatment in VPA group respectively (t =2.603,3.146 ; P =0.003,0.008,respectively).The log (DHEAS) level of baby girls and baby boys were higher in LTG group after treatment than those before treatment respectively(t =3.185,2.663 ;P =0.007,0.041).Conclusion Infantile spasms would not influence the hormone metabolism,while VPA and LTG can influence the sex hormone.The hormone level should be monitored in the treatment.