背景:耐药性癫痫被定义为尽管在适当的时间使用2或3种适当的抗癫痫药物,但癫痫发作控制失败。矿物质元素在神经元功能中起重要作用;据信矿物质缺乏可能通过癫痫发作管理导致并发症。在本研究中,血清锌(Zn)水平,铜(Cu),镁(Mg),钙(Ca),对耐药癫痫(DRE)患者的25-羟基维生素D(VitD)进行了评估,并与对照组患者进行了比较。
方法:在这项横断面研究中,癫痫患者被纳入研究,并分为DRE组和控制良好的患者两组.分析患者血清样本以评估锌,Cu,Mg,Ca,和VitD级。主要目的是比较各组之间不同微量元素的血清水平。
结果:64例癫痫儿童,包括33例DRE和31例控制良好的儿童进入研究。与另一组相比,DRE儿童的疾病发作明显较早(p=0.014)。比较两组之间发育迟缓的频率,结果显示,这种并发症在DRE组中明显更常见(p<0.001).关于血清元素,结果显示,良好控制组的Zn浓度明显高于DRE组(p=0.007)。另一方面,两组之间在VitD的均值方面没有观察到显着差异,Ca,Cu,和Mg水平(p>0.05)。
结论:本研究的结果表明,与控制良好的癫痫患者相比,耐药癫痫患者发病较早,神经发育迟缓的风险更高。耐药癫痫患者的血清锌水平也显着降低。这一发现可能表明补锌有助于更好地控制抗药性癫痫发作的作用,还有,癫痫患者血清锌监测的重要性。
BACKGROUND: Drug-resistant epilepsy is defined as failure of seizure control in spite of using 2 or 3 proper antiepileptic drugs in appropriate time. Mineral elements play important roles in neuronal function; it is believed that mineral deficiency may lead to complications through seizure management. In the present study, serum levels of zinc (Zn), copper (Cu), magnesium (Mg), calcium (Ca), and 25-hydroxy vitamin D (Vit D) in drug-resistant-epilepsy (DRE) patients were evaluated and compared with the controlled patients.
METHODS: In this cross-sectional study, epileptic patients were included and categorized into two groups of DRE and well-controlled patients. Patients\' serum samples were analysed to evaluate Zn, Cu, Mg, Ca, and Vit D levels. The primary objective was comparison of serum levels of different trace elements between the groups.
RESULTS: Sixty-four epileptic children including 33 DRE and 31 well-controlled children entered the study. The DRE children showed a significantly earlier onset of disease compared to the other group (p = 0.014). Comparing the frequency of developmental delay between the groups, the results showed this complication was significantly more frequent in the DRE group (p < 0.001). Concerning serum elements, the results showed a significantly higher concentration of Zn in the well-controlled group than the DRE group (p = 0.007). On the other hand, no significant differences were observed between the groups regarding the means of Vit D, Ca, Cu, and Mg levels (p > 0.05).
CONCLUSIONS: The results of the present study delineated that drug-resistant epilepsy patients had earlier onset of disease and were at higher risk of neurodevelopmental delay compared with well-controlled-epilepsy patients. A significant lower serum levels of Zn were also observed in drug-resistant-epilepsy patients. This finding may suggest the role of zinc supplementation in help to better control of drug-resistant seizures, as well as, the importance of serum zinc monitoring in epileptic patients.