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The long-term follow-up of height in children with epilepsy

소아 간질 환자에서 장기적인 신장 변화의 추적 관찰

  • We, Ju Hee (Department of Pediatrics, School of Medicine, Pusan National University) ;
  • Nam, Sang Ook (Department of Pediatrics, School of Medicine, Pusan National University)
  • 위주희 (부산대학교 의학전문대학원 소아과학교실) ;
  • 남상욱 (부산대학교 의학전문대학원 소아과학교실)
  • Received : 2008.04.22
  • Accepted : 2008.09.01
  • Published : 2008.10.15

Abstract

Purpose : To assess the height growth of children with epilepsy receiving antiepileptic drugs (AEDs) and the related factors. Methods : The subjects were 148 children diagnosed with epilepsy at Pusan National University Hospital between January 1996 and December 2003, who received AEDs for more than 3 y. We measured height at the initiation of AED medication and at the last visit during AED medication. We analyzed the mean height standard deviation score (SDS) according to several factors, including sex, age at initial medication, seizure type, underlying causes of epilepsy, seizure frequency before AED medication, seizure control, number of AEDs, height SDS before medication, and duration of medication. Results : In the total population, height SDS at initial therapy and last follow-up were $-0.06{\pm}1.39$ versus $0.10{\pm}1.12$ (P=0.09). Children with controlled seizures showed a significant increase in height SDS, from $-0.12{\pm}1.39$ to $0.10{\pm}1.09$ (P=0.04), and children on medication for less than 6 y showed a significant increase in height SDS, from $-0.09{\pm}1.54$ to $0.21{\pm}1.07$ (P=0.03). Also, children with negative initial height SDS showed a significant increase in height SDS (P<0.05). No height SDS changes were observed in any of the other groups, regardless of sex, seizure type, underlying causes of epilepsy, or age at initial medication. Conclusion : Neither epilepsy nor AED medication affects long-term height growth. Controlled seizure and short duration of AED medication are positive factors for height growth in children with epilepsy.

목적: 소아 간질 환자에서 장기적인 신장의 변화 및 그에 영향을 미치는 인자들에 대해 연구하고자 하였다. 방법: 1996년 1월부터 2003년 12월까지 부산대학병원 소아과에서 처음으로 간질 진단을 받은 577명 중 최소 3년 이상 항경련제를 복용한 148명(남아 82명, 여아 66명)을 대상으로 전향적 연구를 시행하였다. 항경련제 복용 시작부터 매년 신장 측정을 하였고 성별, 경련의 형태, 간질의 원인, 항경련제 복용 전 경련 횟수, 경련 조절, 단일 및 복합약물요법, 항경련제 복용 전 신장, 복용시작 나이, 복용 기간과 같은 인자들에 따라 복용 전과 최종 방문시의 신장의 변화를 SDS를 구하여 비교 분석하였다. 결 과: 대상 환아의 항경련제 복용 시작 시 평균 연령은 6.69세였고, 평균 복용 기간은 5.76년이었다. 항경련제 복용 전의 평균 신장 SDS는 -0.059였고 복용 후에는 0.101이었다(P=0.09). 복용 전 경련 횟수가 1개월에 1회 미만인 군(P=0.09), 단일 약물군(P=0.06)에서는 신장 SDS가 증가하였으나 통계적인 유의성은 보이지 않았다. 또 복용 후에 경련 조절이 잘 되었던 군(P=0.04), 복용 전의 신장 SDS가 (-)인 군(P=0.001)과 복용 기간이 6년 미만인 군(P=0.02)에서는 신장의 SDS가 유의한 증가를 보였다. 그 외의 군에서는 항경련제 복용 전과 복용 후 평균 신장 SDS에 유의한 차이가 발생하지 않았다. 결론:정상 경구 식이를 하는 소아 간질 환자에서 항경련제 투여 후 신장 성장은 통계적으로 유의하게 증가하지 않았다. 하지만 경련 조절이 잘 되는 군과 항경련제 치료 기간이 짧았던 군에서 신장 성장이 유의하게 증가하였다.

Keywords

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