奥卡西平或卡马西平引起的低钠低氯血症研究
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摘要
目的探讨奥卡西平或卡马西平引起不同发作类型癫痫患者出现低钠低氯血症的一般规律及特点,初步探讨其可能的发生机制。方法选取2007年11月至2018年9月就诊于山东第一医科大学第二附属医院且规范使用奥卡西平或卡马西平单药治疗的癫痫患者,发现低钠及低氯血症患者17例,生化检验由日立7600全自动生化分析仪完成。结果 17例不同发作类型的癫痫患者服用奥卡西平或卡马西平2～3周后,血清钠离子浓度降低,其中6例服用奥卡西平的患者出现血清氯离子浓度降低。奥卡西平或卡马西平治疗癫痫全面性发作和局灶性发作前后比较血清钠离子浓度有差异。奥卡西平或卡马西平治疗前后,癫痫全面性发作的患者与局灶性发作的患者比较血清钠离子浓度均无差异。结论奥卡西平或卡马西平对全面性发作和局灶发作治疗有效,但可导致部分癫痫患者发生血清钠离子及氯离子浓度水平降低,血清钠离子和氯离子降低与发作类型无关。
Objective: To investigate the general rules and characteristics of hyposodium hypochloremia in patients with different seizure types caused by occasepine or carbamazepine, and to investigate the possible mechanism of its occurrence. Methods: Epilepsy patients who were treated with oxcarbazepine or carbamazepine from November 2007 to September 2018 were selected. Seventeen patients with low sodium and hypochloremia were found,and biochemical tests were completed by Hitachi 7600 automatic biochemical analyzer. Results: The serum sodium concentration of the 17 epileptic patients with different seizure types decreased after treated with oxcarbazepine or carbamazepine for 2 ～ 3 weeks,and 6 cases of them,who treated by oxcarbazepine,had lower serum chloride concentration. There were differences in serum natrium concentration before and after oxcarbazepine or carbamazepine in the treatment of generalized epileptic seizures and focal seizures. There was no difference in serum sodium concentration between patients with generalized seizure and patients with focal seizure before and after treatment with oxcarbazepine or carbamazepine. Conclusion: Oxcarbazepine or carbamazepine is effective in the treatment of generalized and focal seizures,but it can lead to the decrease of serum sodium and chloride concentration in some epileptic patients. The decrease of serum sodium and chloride ion is not related to the type of seizures.
Objective: To investigate the general rules and characteristics of hyposodium hypochloremia in patients with different seizure types caused by occasepine or carbamazepine, and to investigate the possible mechanism of its occurrence. Methods: Epilepsy patients who were treated with oxcarbazepine or carbamazepine from November 2007 to September 2018 were selected. Seventeen patients with low sodium and hypochloremia were found,and biochemical tests were completed by Hitachi 7600 automatic biochemical analyzer. Results: The serum sodium concentration of the 17 epileptic patients with different seizure types decreased after treated with oxcarbazepine or carbamazepine for 2 ～ 3 weeks,and 6 cases of them,who treated by oxcarbazepine,had lower serum chloride concentration. There were differences in serum natrium concentration before and after oxcarbazepine or carbamazepine in the treatment of generalized epileptic seizures and focal seizures. There was no difference in serum sodium concentration between patients with generalized seizure and patients with focal seizure before and after treatment with oxcarbazepine or carbamazepine. Conclusion: Oxcarbazepine or carbamazepine is effective in the treatment of generalized and focal seizures,but it can lead to the decrease of serum sodium and chloride concentration in some epileptic patients. The decrease of serum sodium and chloride ion is not related to the type of seizures.
引文
[1]Fisher RS,Acevedo C,Arzimanoglou A,et al.ILAE official report:apractical clinical definition of epilepsy[J].Epilepsia,2014,55(4):475-482.
[2]Falco-Walter JJ,Scheffer IE,Fisher RS.The new definition and classification of seizures and epilepsy[J].Epilepsy Res,2018,139:73-79.
[3]瞿治平.癫痫发作分类及药物临床疗效评定的建议[J].中国神经精神疾病杂志,1980,6(4):248-251.
[4]Bermejo PE,Dorado R,Belarrinaga B.Experience with eslicarbazepine in patients with hiponatremia due to carbamazepine and oxcarbazepine[J].Rev Neurol,2015,61(1):47-48.
[5]Fricke-Galindo I,LLerena A,Jung-Cook H,et al.Carbamazepine adverse drug reactions[J].Expert Rev Clin Pharmacol,2018,11(7):705-718
[6]Berghuis B,van der Palen J,de Haan GJ,et al.Carbamazepineand oxcarbazepine-induced hyponatremia in people with epilepsy[J].Epilepsia,2017,58(7):1227-1233
[7]Intravooth T,Staack AM,Juerges K,et al.Antiepileptic drugs-induced hyponatremia:Review and analysis of 560 hospitalized patients[J].Epilepsy Res,2018,143:7-10.
[8]Kim YS,Kim DW,Jung KH,et al.Frequency of and risk factors for oxcarbazepine-induced severe and symptomatic hyponatremia[J].Seizure,2014,23:208-212.
[9]Dong X,Leppik IE,White J,et al.Hyponatremia from oxcarbazepine and carbamazepine[J].Neurology,2005,65:1976-1978.
[10]Berghuis B,de Haan GJ,van den Broek MP,et al.Epidemiology,pathophysiology and putative genetic basis of carbamazepine-and oxcarbazepine-induced hyponatremia[J].Eur J Neurol,2016,23(9):1393-1399.
[2]Falco-Walter JJ,Scheffer IE,Fisher RS.The new definition and classification of seizures and epilepsy[J].Epilepsy Res,2018,139:73-79.
[3]瞿治平.癫痫发作分类及药物临床疗效评定的建议[J].中国神经精神疾病杂志,1980,6(4):248-251.
[4]Bermejo PE,Dorado R,Belarrinaga B.Experience with eslicarbazepine in patients with hiponatremia due to carbamazepine and oxcarbazepine[J].Rev Neurol,2015,61(1):47-48.
[5]Fricke-Galindo I,LLerena A,Jung-Cook H,et al.Carbamazepine adverse drug reactions[J].Expert Rev Clin Pharmacol,2018,11(7):705-718
[6]Berghuis B,van der Palen J,de Haan GJ,et al.Carbamazepineand oxcarbazepine-induced hyponatremia in people with epilepsy[J].Epilepsia,2017,58(7):1227-1233
[7]Intravooth T,Staack AM,Juerges K,et al.Antiepileptic drugs-induced hyponatremia:Review and analysis of 560 hospitalized patients[J].Epilepsy Res,2018,143:7-10.
[8]Kim YS,Kim DW,Jung KH,et al.Frequency of and risk factors for oxcarbazepine-induced severe and symptomatic hyponatremia[J].Seizure,2014,23:208-212.
[9]Dong X,Leppik IE,White J,et al.Hyponatremia from oxcarbazepine and carbamazepine[J].Neurology,2005,65:1976-1978.
[10]Berghuis B,de Haan GJ,van den Broek MP,et al.Epidemiology,pathophysiology and putative genetic basis of carbamazepine-and oxcarbazepine-induced hyponatremia[J].Eur J Neurol,2016,23(9):1393-1399.