抗癫痫药物对婴幼儿骨代谢的影响  

Effect of Antiepileptic Drugs on Bone Metabolism in Infants and Toddlers with Epilepsy

作　　者：陈丽婷 曾甲斌[1] 柯钟灵 林希[1] 陈素清[1] 吴斌[1] CHEN Liting;ZENG Jiabin;KE Zhongling;LIN Xi;CHEN Suqing;WU Bin(Department of Pediatrics,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院儿科,福州350005

出　　处：《福建医科大学学报》2021年第4期314-317,共4页Journal of Fujian Medical University

基　　金：福建省卫生厅青年科研基金项目(2014-1-50)。

摘　　要：目的探讨抗癫痫药物对婴幼儿骨代谢的影响。方法研究组为32例采用抗癫痫药物治疗的婴幼儿,检测患儿血总1型胶原氨基端延长肽(TP1NP)、β胶原降解产物(β-CTX)、25羟基维生素D(25-OHD)、N端骨钙素(NMID)水平。对照组为22例癫痫初诊未用药的婴幼儿。结果研究组的TP1NP、β-CTX、25-OHD水平与对照组无明显差异(P>0.05),而NMID水平较对照组明显升高(P<0.05)。抗癫痫治疗≤1 a组与>1 a组的TP1NP水平差别有统计学意义(P<0.05),>1 a组的TP1NP水平下降。单药治疗组与多药治疗组骨代谢指标无明显差异。丙戊酸钠单药治疗组的β-CTX水平较奥卡西平单药治疗组升高。结论抗癫痫药物对婴幼儿的骨代谢可能有影响,疗程长的婴幼儿骨合成能力下降;丙戊酸钠较奥卡西平更易影响婴幼儿的骨吸收。Objective To investigate the effect of antiepileptic drugs on bone metabolism in infants and toddlers with epilepsy.Methods 32 infants/toddlers in the study group were treated with antiepileptic drugs.The levels of total N-terminal propeptide of type 1 procollagen(TP1NP),β-collagen specific sequences(β-CTX),25-hydroxy vitamin D(25-OHD)and N-terminal midfragment of osteocalcin(NMID)were tested.The control group consisted of 22 epileptic infants/toddlers without treatment.Results There was no significant difference in TP1NP,β-CTX and 25-OHD between the study group and the control group(P>0.05),However,the NMID level in the study group was significantly higher than that in the control group(P<0.05);there was a significant difference(P<0.05)in TP1NP levels between the group with≤1 year of antiepileptic treatment and the group with>1 year,and TP1NP levels decreased in the group with>1 year of antiepileptic treatment;there was no significant difference in bone metabolism indexes between the monotherapy group and polytherapy group;and theβ-CTX level in the sodium valproate group was higher than that in the oxcarbazepine group.Conclusion Antiepileptic drugs may have an effect on bone metabolism in infants and toddlers,osteosynthesis decreased in infants and toddlers on a long course of antiepileptic drugs,and sodium valproate is more likely to affect bone resorption than oxcarbazepine in infants and toddlers.

关 键 词：抗癫痫药物 骨代谢 婴幼儿 

分 类 号：R969[医药卫生—药理学]