目的观察长期应用托吡酯、丙戊酸钠单药治疗对癫痫患者血脂水平的影响。方法连续入组长期单药应用丙戊酸钠控制良好的癫痫患者28例、单药应用托吡酯控制良好的癫痫患者30例，并选取健康对照60例，观察各组间血脂代谢指标的差异。结果丙戊酸钠组血清脂蛋白（a）水平显著高于托吡酯组（P<0.001）及健康对照组（P=0.003），而总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯水平较其他两组无明显差异。托吡酯组的总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、脂蛋白（a）、甘油三酯水平较对照组均未有显著差异。结论长期单药应用丙戊酸钠有可能增加癫痫患者脂蛋白（a）的水平，而长期单药应用托吡酯对于血脂水平影响并不明显。%Objective To assess the effects of long-term topiramate and valproate sodium monotherapy on serum lipids in patients with epilepsy. Methods Fifty eight adult epilepsy patients who were on antiepileptic drug monotherapy (30 receiving topiramate and 28 receiving valproate sodium) for more than 12 months were recruited. Sixty age and sex matched healthy adults were enrolled in this study as the control group. Serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) and triglycerides (TG) were measured in all participants after overnight fasting. Results The group which received the valproate sodium monotherapy showed increased levels of serum lipoprotein(a) except for TC, LDL-C, HDL-C and TG (P>0.05) when compared to the group receiving topiramate (P<0.001) as well as the controls (P=0.003). The group receiving the topiramate monotherapy demonstrated insigniifcant changes in cholesterol (TC, LDL-C, HDL-C), TG and lipoprotein(a) levels in comparison with the control group. Conclusion Serum lipoprotein(a) level was substantially increased in epilpesy patients on a long-term monotherapy with valproate sodium, whereas long-term topiramate monotherapy might have a minor effect on serum lipids.
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