抗癫痫药物对癫痫患儿骨密度的影响及与骨代谢和体格发育的相关性  

Effect of antiepileptic drugs on bone mineral density in children with epilepsy and its correlation with bone metabolism and physical development

作　　者：田增春 朱彩华 张淼[1] 梁璐[1] Tian Zengchun;Zhu Caihua;Zhang Miao;Liang Lu(Nanyang Central Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《临床心身疾病杂志》2022年第3期23-28,共6页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划项目(编号2018062132)。

摘　　要：目的探讨抗癫痫药物治疗对癫痫患儿骨密度的影响及与骨代谢和体格发育的相关性。方法对150例癫痫患儿给予抗癫痫药物治疗(脱落6例),治疗1 a后检测骨密度,统计骨密度异常发生率,根据是否发生骨密度异常分为骨密度异常组58例和骨密度正常组86例,比较两组相关临床资料,分析抗癫痫药物治疗癫痫患儿发生骨密度异常的影响因素。治疗1 a后比较两组骨密度、血钙、血磷、血清骨碱性磷酸酶、血清骨钙素、身高、体质量,分析骨密度与骨代谢指标、体格发育指标的相关性。结果癫痫患儿抗癫痫药物治疗1 a后骨密度异常发生率为40.3%。两组抗癫痫药物数量、抗癫痫药物种类、户外活动时间、定期补充维生素D情况比较差异有统计学意义(P<0.01)。多药治疗、采用传统抗癫痫药物治疗、户外活动时间少、未定期补充维生素D均为骨密度异常的危险因素。癫痫患儿抗癫痫药物治疗1 a后骨密度与血钙、血磷、血清骨钙素、身高、体质量呈显著正相关(P<0.05),与血清骨碱性磷酸酶呈显著负相关(P<0.05)。结论癫痫患儿抗癫痫药物治疗期间骨密度异常发生率较高,多药治疗、传统抗癫痫药物治疗、户外活动时间少、未定期补充维生素D均可增加骨密度异常发生风险,骨密度异常与骨代谢、体格发育密切相关。Objective To explore the effect of antiepileptic drugs(AEDS)on bone mineral density(BMD)in children with epilepsy and its correlation with bone metabolism and physical development.Methods A total of 150 children with epilepsy were treated with AEDS(6 cases dropped out).After 1 year of treatment,BMD was tested and the incidence of abnormal BMD was counted.According to whether BMD abnormality occurred,they were divided into abnormal BMD group(58 cases)and normal BMD group(86 cases).The clinical data of the two groups were compared,and the influencing factors of abnormal BMD in children with epilepsy treated with AEDS were analyzed.After 1 year of treatment,BMD,serum calcium,blood phosphorus,bone alkaline phosphatase(BAP),osteocalcin,height and body weight were compared between the two groups.Results The abnormal incidence of BMD in children with epilepsy after 1 year of AEDS treatment was 40.28%.There were significant differences in the number of AEDS,the type of AEDS,the time of outdoor activities,and regular vitamin D supplementation between the two groups(P<0.01).Polypharmacy,traditional AEDS therapy,less time for outdoor activities,and lack of regular vitamin D supplementation were all risk factors for abnormal BMD.After 1 year of antiepileptic drug treatment in children with epilepsy,BMD was significantly positively correlated with serum calcium,blood phosphorus,serum osteocalcin,height and body weight(P<0.05),and was significantly negatively correlated with serum BAP(P<0.05).Conclusions The incidence of abnormal BMD is higher in children with epilepsy during AEDS treatment.Polypharmacy,traditional AEDS therapy,less time for outdoor activities,and lack of regular vitamin D supplementation all increase the risk of abnormal BMD.Abnormal BMD is closely related to bone metabolism and physical development.

关 键 词：癫痫 患儿 抗癫痫药物 骨密度 骨代谢 体格发育 

分 类 号：R742.1[医药卫生—神经病学与精神病学]