간질환아에서의 항경련약제의 장기치료가 혈청 면역글로불린에 미치는 영향

Changes of Serum Immunoglobulin Levels on Long-term Anticonvulsant Therapy in Epileptic Children

저자들은 장기간 항경련약제로 치료한 간질 소아에서 혈청 면역글로불린의 변화를 알아보기 위하여 정상군 55명과 환아군 68명을 대상으로 혈청 IgA, IgG, IgM값을 각각 측정하여 다음과 같은 성적을 얻었다. 1. 혈청 IgA 의 평균값은 항경련약제 치료를 한 각 연령군의 환아군에게 현저하게 감소되었으며, 이는 통계학적으로 유의한 차를 보였다(P<0.05). 2. 혈청 IgG와 IgM의 평균값은 각 연령군의 정상군과 환아군 사이에 유의한 차가 없었다. 3. 정상군의 각연령군별 혈청 IgA평균값에서 2표준편차 이하의 낮은 값을 보인 환아는 환아군 68명중 12명(17.6%)에서 있었다. 이들 12명을 치료한 항경련약제별로 보면 9명은 phenytoin을, 1명은 valproate를, 나머지 2명은 phenytoin과 phenobarbital을 병용 치료한 환아이었다. 혈청 IgA의 낮은 값은 phenytoin치료군에게 가장 많아 환아 32명중 9명(28.1%)에서 있었다. 이와 같은 결과로 항경련약제의 장기 치료는 혈&#52453; 면역글로불린 가운데 주로 IgA에 변화를 보였으며 낮은 혈청 IgA값은 여러 항경련약제중 특히 phenytoin치료와 관련이 있었다.

Aberrations of serum levels of immunoglobulin have been demonstrated in some patients with epilepsy receiving anticonvulsant drugs. The most constant finding is an abnormally low serum level of IgA in phenytoin treated patients. Changes in IgG and IgM levels have also been found. but the results are conflicting. However, little is known about the effect of other anticonvulsant drugs upon serum immunoglobulins. Authors therefore started this study to assess the humoral immune response to various anticonvulsant drugs in epileptic children. The study included 68 epileptic children(male 43, female 25) taking anticonvulsant drug for minimum of 4 and a maximum of 33 months at the time of testing and a control group of age matched 55 healthy children(male 32, female 23), Sera were collected from all patients and controls and stored at -20℃ until analysis. The serum levels of IgA, IgG and IgM were determined by using immunodiffusion plate of low level test(LC-Partigen). For statistical evaluation, the difference between two groups was tested by Student's t-test. The results obtained in this study were summarized as follows: 1. The mean serum level of IgA was significantly lower in the patients than the controls in each age groups(P <0.05). 2. The mean serum levels of both IgG and IgM in the patients were not statistically different from those obtained in controls in each age groups. 3. Twelve of 68 patients(17.6%) who received anticonvulsant drugs had low serum IgA level below 2 S.D. from the normal mean in each age groups. Of the 12 patients. 9 were treated with phenytoin. one with valproate and remaining 2 with combination of phenytoin and phenobarbital. An abnormally low IgA was most common in phenytoin treated patients and it was observed in 9 of 32 children (28.1%)