| Objective: The aims of this study were to investigate the effect of topiramate (TPM) on acid-base balance, electrolytes metabolism and the function of kidney in epilepsy children. By observing the changes of blood and gas analysis, N-acetyl-β-D-glucosaminide (EC 3.2.1.30, NAG) in the urine of 24 hours, β2-M in blood and urine, globulin in urine, and albumin in urine, this study was to explore the regulations in the change and evaluate the security of TPM in the children. Method 1 Experiment design: All 24 epilepsy children were divided into two groups: Single drug group (TPM only; 13 children) and Combined drug group (combination of TPM with CBZ, NZP, VPA or PB; 11 children). They had normal function of liver and kidney and got no other illness in the period of treatment. 2 Measuring index: Assessment parameters included analysis of blood gas and electrolytes (pH, Pco2, Po2, HCO3-, BE, Na+, K+, Ca2+, Cl-, AG), evaluation of kidney function (NAG in the urine of 24 hours, β2-M in blood and urine, globulin in urine, and albumin in urine). The changes were observed in three different time, before TPM, 3 months after TPM and 6 months after TPM. Results 1 Blood and gas analysis 1.1 This study showed that the epilepsy children in the single drug group and the combined drug group have the nomal blood and gas analysis before TPM, and their blood HCO3-(mmol/L) was 22.84±1.38 and 21.82±2.73, respectively. In the 3 and 6 months after TPM, the blood HCO3-showed significant fall in the two groups (F=94.11,P<0.001 and F=20.79, P<0.001), compared with before TPM. In 3 months after TPM, the HCO3-(mmol/L) were the least (16.46±1.14 and 16.32±0.96), and the average decrease in the best evidence were 27.92% and 25.17%, respectively. There were the significant difference (Q=18.11,P<0.01 and Q=8.88,P<0.01) compared with before TPM. In 6 months after TPM, the HCO3-(mmol/L) were 17.46±1.28 and 17.99±2.05, and the average decrease were 23.55% and 17.54%, respectively. There were the significant difference (Q=15.27,P<0.01 and Q=6.19,P<0.01) compared with before TPM. But the HCO3-in the 3 months after TPM were higher than those in the 6 months after TPM, with no significant difference (Q=2.84,P >0.05 and Q=2.69,P >0.05) between them. The descend rates in the two groups had no significant difference (X2=0.11, P=0.95). All the epilepsy children had the mild acidosis and no evidence symptom, with the blood HCO3-(mmol/L) were 14～18 (100%). 1.2 The BE (mmol/L) before TPM was -1.92±2.21and -2.61±2.60 in two groups, respectively. In the 3 and 6 months afterTPM, the BE were in evidence fall in the two groups, and had the significant difference (F=62.90,P<0.001 and F=19.89, P<0.001) compared with before TPM. In 3 months after TPM, the BE (mmol/L) were the least (-8.49±1.12 and -8.14±1.22), and the average decrease were 342.19% and 211.88%, respectively. There were the significant difference (Q=15.18,P<0.01and Q=8.55,P<0.01) compared with before TPM. In 6 months after TPM, the BE (mmol/L) were -6.93±1.08 and -6.78±2.36, and the average decrease were 260.93% and 159.78%, respectively. There were the significant difference (Q=11.58,P<0.01and Q=6.44,P<0.01) compared with before TPM. But the BE in the 3 months after TPM were higher than those in the 6 months after TPM, with no significant difference (Q=3.60,P<0.05) between them in the single drug group and with significant difference (Q=2.10,P >0.05) in the combined drug group. The descend rates in the two groups had no significant difference (X2=0.17, P=0.92). 1.3 At the same time this study showed that the changes in Pco2 was similar with HCO3-, neither was Po2. All children showed the normal AG and pH, and no significant difference. 1.4 Six epilepsy children gave up the medicine incapable of the side effect showed the nomal blood gas parameters such as pH, Pco2, Po2, HCO3-, BE, and AG. 2 Electrolytes 2.1 In the 3 and 6 months after TPM, the Blood Cl-were in evidence increased in the two groups, and had the significantdifference (F=29.37, P<0.001 and F=25.12, P<...
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