含苯妥英钠抗癫痫药物治疗方案对骨密度和骨代谢影响的系统评价  

A system evaluation of the effect of antiepileptic drug regimen including phenytoin on bone mineral density and bone metabolism in patients with epilepsy

作　　者：刘萌[1] 张瑞麟[2] 雷兆锦[1,2] 李忠东[1,2] 

机构地区：[1]安徽医科大学空军临床学院,合肥230032 [2]空军总医院药学部,北京100142

出　　处：《中国新药杂志》2013年第19期2286-2291,2295,共7页Chinese Journal of New Drugs

基　　金：首都医学发展基金(2009-2055)

摘　　要：目的:评价含苯妥英钠抗癫痫药物治疗方案对癫痫患者骨密度及骨代谢的影响。方法:在主要电子数据库检索文献(截止至2013年3月),纳入所有包含苯妥英钠抗癫痫药物且有对照试验研究的文献,用RevMan 5及Stata 12.0软件进行Meta分析。结果:共纳入包括12 303例受试者在内的9个队列研究。结果显示,与对照组相比,服用抗癫痫药物的患者腰椎骨密度和血清25羟维生素D水平分别下降0.9(95%CI:-1.73,0.08,P=0.03)和0.48个标准单位(95%CI:-0.67,-0.030,P<0.000 01),血清碱性磷酸酶升高0.73个标准单位(95%CI:0.4,1.05,P<0.000 01)。结论:对服用含苯妥英钠抗癫痫药物的患者,应定期检查其腰椎骨密度、25羟维生素D和血清碱性磷酸酶的变化。Objective： To determine the effect of antiepileptic drugs including phenytoin on the bone min- eral density （BMD） and bone metabolism. Methods： Major electronic databases were searched （to March, 2013）. Data from published controlled trials with antiepileptic drugs including phenytoin, or without drugs （con- trol） , were pooled using a meta-analytic method by RevMan 5 and Stata 12.0 software. Results： A total of 9 pa- pers involving 12 303 patients were identified. Compared to control group, lumbar BMD and 25-hydroxyvitamin D of patients in the group with antiepileptic drugs including phenytoin were decreased by 0.90 （95% CI： -1.73, 0.08,P=0.03） and0.48 （95% CI： -0.67, -0.030,P〈0.00001）, but the alkaline phosphatase increased by 0.73 （95 % CI ： 0. 4,1.05, P 〈 0. 000 01 ）. Conclusion ： For patients treated by long-term antiepileptic drugs in- cluding phenytoin, it is required to monitor the alteration of their lumbar BMD, blood 25-hydroxyvitaminD and al- kaline phosphatase regularly.

关 键 词：抗癫痫药物 苯妥英钠 骨密度 骨代谢 META分析 

分 类 号：R971[医药卫生—药品]