- 期刊
Urinary N-Acetyl-Beta-Glucosaminidase (NAG) in Children Receiving Antiepileptic Drugs
服用抗癲躪藥病童尿中之N-Acetyl-Beta-Glucosaminidase (NAG)活性
摘要
本研究包含102位癲瘸病童，年齡16個月至14歲，服用抗癲瘸藥物至少一個月以上給於測定尿中NAG活性，並與正常孩童之NAG值比較。102位病童中，有40位(39%)病童有NAG值高的現象。於83位服用單一抗癲癇藥物中有29位(35%)之NAG值昇高：55例使用carbamazepine者有14例、4例使用phenytoin有l例、8例使用Phenobarbital有5例、9例使用valproic acid有7例、5例使用ethosuximide有2例、2例使用primidone沒有人NAG值昇高。使用valproic acid有較高的比率有不正常尿中NAG值，可能其與腎小管細胞的傷害最有關係。而各癲癇藥物濃度的高低與NAG的正常與否並無有意義的相關。於19位服用多種抗癲癇藥物中有11位NAG值不正常，服用藥物的多寡與尿中NAG增加的比率並無相關。本研究指出抗癲癇藥物確有可能造成腎小管傷害，但必須更進一步的研究來確定此種腎小管傷害是否為可逆。
關鍵字
無資料並列摘要
The activity of urinary N-acetyl-beta-glucosaminidase (NAG) was measured in random urines using the ratio (NAG index) of NAG to grams of urine creatinine in 102 epileptic children taking antiepileptic drugs (AEDs). A high urinary NAG index (2 SD or more above the mean for the age-matched control/normal subjects) was dected in 40 (39%, 40/102) epileptic children with AEDs. None of the 40 epileptic children with abnormal urinary NAG excretion had significant proteinuria. Among the 83 epileptic children under mono therapy, 29 cases (35%) had elevated urinary NAG excretion. Valproic acid presented the highest incidence of abnormal urinary NAG index (78%, 7/9 cases) within the monotherapy group, and the incidence was statistically significantly higher than that (26%, 14/55) in the carbamazepine group (p＜0.05). In the monotherapy group, no significant difference in serum levels of AEDs was found between children with normal urinary NAG excretion and those with abnormal. Nineteen epileptic children were treated with more than one AEDs. Eleven of them (58%, 11/19 cases) had a high urinary NAG index. The incidence of high urinary NAG index in the polytherapy group and that in monotherapy group was not significantly different (p＞0.05). This study suggests that AEDs may be potentially nephrotoxic and that urinary NAG may play a role in screening renal tubular injury in epileptic children under therapy of AEDs. Further investigation should be conducted to determine whether the effect of AEDs on renal tubular cells is or is not reversible.