【摘要】 目的 服用丙戊酸钠(VPA)抗癫痫治疗的患者，15%~70%的成人可发生体重增加[1-2]，而瘦素在体重和能量平衡的调节中起重要影响，近年来许多研究表明VPA引起的体重改变可能与瘦素有关。探讨丙戊酸钠抗癫痫治疗对血清瘦素的影响，该影响与患者体重改变的相关性，以及瘦素的可能机制。方法 以丙戊酸钠治疗超过3个月的33例癫痫患者为治疗组,20例未经丙戊酸钠治疗癫痫患者作为对照组来比较，检测患者体重、身高、血清瘦素水平,比较两组的体重指数(BMI)、血清瘦素水平。结果 丙戊酸钠治疗组的血清瘦素(8.8503±4.7924)ug/ml与对照组(2.8490±1.3962)ug/ml比较有增高，治疗组BMI(23.7202±2.5182)高于对照组(20.8468±1.6815)。结论 丙戊酸钠治疗可能引起血清瘦素、体重指数增高，很可能通过诱导导致瘦素抵抗的机制之一，从而导致患者体重增加。

    【关键词】 丙戊酸钠 药物治疗 瘦素

    The Role of Sodium Valproate Therapy in Change of Plasma Leptin level of Epileptic Patients

    Zhang Yipan,et al.

    (Internal Medicine of Nerve Department,Affiliated Hospital of Putian Medical College,Fujian351100,China)

    【Abstract】 Objective To investigate the possible role of VPA therapy in the change of the plasma leptin level of epileptic patients and development of the weight gain,also the mechanism of leptin resistance.Methods The weight and fasting leptin levels were measured 33 epileptic patients treated with VPA alone over 3 months and 21 epileptic patients without therapy.The body mass index (BMI) and the plasma leptin level were studied in the two groups.Results The plasma leptin level and the body mass index (BMI) in the VPA-treated groups were higher [(8.8503±4.7924)ug/ml and(23.7202±2.5182)] than those in the control subjects [(2.8490±1.3962)ug/ml,P<0.05;(20.8468±1.6815),P<0.05].Conclusions VPA therapy over 3 months may cause hyperleptinemia and development of leptin resistance. ......