血清维生素D水平对丙戊酸钠治疗癫痫患儿的影响研究OA

Objective:To investigate the influencing factors of serum vitamin D levels in chil-dren with epilepsy treated with valproate sodium and its correlation with seizure control,so as to provide evidence for the monitoring and intervention of serum vitamin D levels during long-term anti-epileptic treatment.Methods:A retrospective study was conducted invol-ving 90 paediatric patients with epilepsy treated with sodium valproate,who were cate-gorised according to their serum vitamin D levels into a deficiency group(n=13),an insuffi-ciency group(n=26)and a sufficient group(n=51).Baseline characteristics and epilepsy control rates were compared across the three groups;the correlation between serum vitamin D levels and age,duration of VPA treatment and plasma drug concentrations was analysed;and the independent effect of vitamin D levels on epilepsy control was assessed using multi-variate logistic regression.Results:There were statistically significant differences in age,duration of VPA treatment and plasma drug concentrations among the three groups(P<0.01);children with lower Vitamin D levels were older and had higher exposure to sodium valproate;however,there were no statistically significant differences in the proportions of patients receiving combination therapy or enzyme-inducing agents(P>0.05).Univariate analysis revealed a statistically significant difference in epilepsy control rates between groups with different Vitamin D levels(x2=7.947,P=0.019),with the control rate in the Vita-min D-sufficient group being higher than in the deficient and insufficient groups.Spearman correlation analysis revealed that serum vitamin D levels were moderately negatively correla-ted with age and duration of VPA treatment(rs=-0.466,-0.445,P<0.001)and weakly negatively correlated with VPA plasma concentrations(rs=-0.264,P=0.012).Following adjustment for confounding factors via multivariate regression,serum 25-OH VD3 levels were not an independent predictor of epilepsy control(OR=1.024,P=0.257);however,the OR value suggested a trend towards a positive association with the epilepsy control rate.Conclusion:Serum vitamin D levels in children with epilepsy receiving valproate sodium are affected by age and drug exposure.Vitamin D level is positively correlated with seizure con-trol rate.Though it is not an independent influencing factor,monitoring and vitamin D sup-plementation should be emphasized.