抗发作药物对患有的儿童甲状腺功能的影响
Dilek Cebeci1, Esra Gurkas1, Nefise Aribas Oz1
1Department of Pediatric Neurology, Children's Hospital, Ankara City Hospital, Cankaya, Ankara, Turkey.
Clinical pediatrics
|February 14, 2025
概括
在患有的儿童中,单独使用莱维他治疗并没有显著改变甲状腺功能. 其他抗发作药物,如氨酸,与甲状腺刺激激素 (TSH) 和亚临床甲状腺功能低下症的增加有关.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 影响全球儿童,需要长期使用抗发作药物 (ASM) 进行治疗.
- 已知一些ASM会导致甲状腺功能障碍,需要监测.
- 新的ASM如 levetiracetam对儿童群体甲状腺功能的影响需要进一步阐明.
研究的目的:
- 评估四种ASM (瓦尔酸盐,费诺巴尔比塔尔,卡巴马西平,莱维他赛坦) 对症儿童甲状腺功能的影响.
- 评估血清甲状腺刺激激素 (TSH) 和自由甲状腺素 (fT4) 水平的变化.
- 为了确定ASM单一治疗期间亚临床甲状腺功能低下症的发生率.
主要方法:
- 一项纵向研究涉及181名儿童患者,他们接受了瓦尔酸盐,费诺巴比塔尔,卡巴马西平或 levetiracetam 单疗法.
- 在基线,6个月,12个月和18个月定期监测血清TSH和FT4水平.
- 在不同ASM群体中比较甲状腺激素水平和亚临床甲状腺功能低下的频率.
主要成果:
- 瓦尔酸盐治疗导致TSH水平显著增加和亚临床甲状腺功能低下的发病率更高 (18个月后16%).
- 与其他ASM相比,12个月和18个月后,卡巴马泽平的使用导致fT4水平较低.
- 单独使用莱维西拉治疗时,TSH或FT4水平没有显著变化,没有亚临床甲状腺功能低下的病例.
结论:
- 在儿科患者的甲状腺功能方面,单疗法似乎是安全的.
- 瓦尔酸盐和,在较小程度上,芬诺巴比他和卡巴马西平可能会在儿童中构成甲状腺功能障碍的风险.
- 建议对儿童进行常规的甲状腺功能监测,这些儿童接受某些ASM,特别是氨酸.
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