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首页> 外文期刊>The Internet Journal of Neurology >Effect Of Anticonvulsant Drugs On Lipid Profile In Epileptic Patients
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Effect Of Anticonvulsant Drugs On Lipid Profile In Epileptic Patients

机译：抗惊厥药对癫痫患者血脂的影响

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One hundred and twenty patients with epilepsy who had been on various anticonvulsant drugs were selected for the study of their lipid profile. We found a significant increase in serum levels of triglyceride, total cholesterol, HDLc and VLDLc in patients receiving combination therapy of either Phenytoin and Phenobarbitone or Phenytoin and Carbamazepine or Phenytoin alone. Patients receiving Carbamazepine alone had significant increase in serum levels of triglyceride and VLDLc but no significant changes in serum levels of total cholesterol & HDLc in this group. A significant correlation between duration of anticonvulsant therapy and lipid profile was established. Our results indicated the long-term use of anticonvulsant therapy significantly raises total cholesterol level and therefore cholesterol should be regularly checked in patients undergoing such treatment. Introduction Epilepsy is one of the most common disorders of the nervous system. Prevalence of epilepsy is estimated at over two million cases in United States (1,2) and there are approximately six million people suffering from epilepsy in India alone with the prevalence rate of 9/1000. In most studies, prevalence rates lie between 4 and 10 per 1000 population (3,4). Recent advances in the diagnosis of epilepsy include the development of clinical classification of epileptic seizures and the recognition of specific epileptic disorders. Though the incidence of seizures complications have decreased with the use of appropriate anticonvulsant therapy but incidence of various metabolic and endocrinal abnormalities remained same despite of treatment in epileptic patients. Anticonvulsant drugs are used in large quantities during long-term antiepileptic therapy and the treatment may be associated with various metabolic abnormalities in connective tissues, endocrine system and the liver (5). Anticonvulsants may alter liver function and increase the activity of hepatic microsomal enzyme system (5,6). This enzyme induction phenomenon is associated with an altered metabolism of various substances such as drugs and lipids (5,6). This anomaly has focused attention on changes in lipid profile during long-term anticonvulsant therapy especially by alter liver function and increase the activity of the hepatic microsomal enzyme system (6,7). The clinical significance of these changes has not yet been clearly established. The present study was undertaken to study the effect of anticonvulsant drugs on serum levels of triglyceride, total cholesterol, HDLc, LDLc and VLDLc. Materials And Methods Patients and specimen collectionOne hundred and twenty cases of epilepsy, which had been on various anticonvulsant drugs for a period varying from 3-15 years, attending epilepsy clinic of Sardar Vallabh Bhai Patel hospital, LLRM medical college, Meerut, UP, were selected for the present study. Patients suffering with diabetes mellitus, nephrotic syndrome, myxoedema and familial hypercholesterolemia, which might affect the blood lipid, were excluded. Sixty healthy individuals preferably relatives of patients were selected to serve as normal control. After an overnight fast, 5 ml blood samples of patient and control were collected in vacuum tubes and allowed to clot at room temperature for 60-120 minute followed by centrifugation at 3000 g for 10 min. at 40C. Serum was stored at -200C, for estimation of lipid profile. Estimation of triglycerideEstimation of triglyceride was performed by method described by Kaplan 1985 (8) by using commercially available kit from Sigma- Aldrich. In Brief, 10 microliter of serum was mixed with 1000 microliter of reaction solution. The absorbance of sample was measured against the reaction solution. The Increase in absorbance, measured at 540 nm, due to the formation the Quinoneimine dye, is directly proportional to the triglyceride concentration in the sample. The increase in absorbance was directly proportional to the glycerol concentration in the sample. True serum trigly
机译：选择了120例服用了各种抗惊厥药物的癫痫患者来研究其血脂状况。我们发现接受苯妥英和苯巴比妥或苯妥英与卡马西平或苯妥英钠联合治疗的患者的血清甘油三酯，总胆固醇，HDLc和VLDLc显着增加。仅接受卡马西平治疗的患者的血清甘油三酯和VLDLc水平显着升高，但该组中总胆固醇和HDLc的血清水平无明显变化。建立了抗惊厥治疗的持续时间与脂质分布之间的显着相关性。我们的结果表明，长期使用抗惊厥疗法会显着提高总胆固醇水平，因此接受这种治疗的患者应定期检查胆固醇。简介癫痫病是神经系统最常见的疾病之一。在美国，癫痫的患病率估计超过两百万例（1,2），仅在印度就有大约六百万人患癫痫病，患病率为9/1000。在大多数研究中，患病率在每1000人口4到10之间（3,4）。癫痫诊断的最新进展包括开发癫痫发作的临床分类和识别特定的癫痫疾病。尽管通过使用适当的抗惊厥治疗降低了癫痫发作并发症的发生率，但是尽管在癫痫患者中进行了治疗，但各种代谢和内分泌异常的发生率仍然相同。长期抗癫痫治疗期间大量使用抗惊厥药物，该治疗可能与结缔组织，内分泌系统和肝脏的各种代谢异常有关（5）。抗惊厥药可能会改变肝功能并增加肝微粒体酶系统的活性（5,6）。这种酶诱导现象与药物和脂质等各种物质的新陈代谢改变有关（5,6）。这种异常集中在长期抗惊厥治疗过程中的脂质分布变化上，特别是通过改变肝功能和增加肝微粒体酶系统的活性（6,7）。这些变化的临床意义尚未明确。本研究旨在研究抗惊厥药物对血清甘油三酸酯，总胆固醇，HDLc，LDLc和VLDLc的影响。材料和方法病人和标本的收集120例使用各种抗惊厥药物治疗了3至15年不等的癫痫病，就诊于密苏里州密拉特LLRM医学院Sardar Vallabh Bhai Patel医院的癫痫诊所。选择用于本研究。排除可能影响血脂的患有糖尿病，肾病综合征，粘液水肿和家族性高胆固醇血症的患者。选择60名健康个体，优选患者的亲属作为正常对照。禁食过夜后，将5 ml的患者和对照组的血液样品收集在真空管中，并在室温下凝结60-120分钟，然后在3000 g下离心10分钟。在40°C下将血清储存在-200℃，用于估计脂质分布。甘油三酸酯的估计使用Kaplan 1985（8）描述的方法，使用可购自Sigma-Aldrich的试剂盒进行甘油三酸酯的估计。简而言之，将10微升血清与1000微升反应溶液混合。测量样品相对于反应溶液的吸光度。由于形成了醌亚胺染料，在540 nm处测得的吸光度增加与样品中的甘油三酸酯浓度成正比。吸光度的增加与样品中甘油的浓度成正比。真血清

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