摘要
目的 :分别探讨两种主要抗癫痫药卡马西平 (CBZ)、丙戊酸钠 (VPA)对骨代谢相关激素的影响 ,为因药物引起的骨代谢异常提供防治措施。方法 :观察了 6 0例年龄在 18～ 4 0岁间的确诊癫痫患者。 30例单独服用丙戊酸钠 ,30例单独服用卡马西平 ,时间≥ 6个月。 5 0例正常成人对照组。每组男女各半。三组均测定其血清 2 5羟基维生素 [2 5 (OH)D]、甲状旁腺激素 (PTH)、降钙素 (CT)、血清钙 (Ca2 + )、血清磷 (P3 + )、碱性磷酸酶(ALP)的浓度。结果 :卡马西平组血清Ca2 + 、P3 + 及 2 5 (OH)D的浓度均较正常对照组低 ,丙戊酸组血清Ca2 + 及2 5 (OH)D的浓度均较正常对照组高。在这两组中血清PTH、CT、ALP的浓度均较正常对照组高。结论 :卡马西平和丙戊酸对骨代谢的影响不同。治疗上应有所侧重。
Objective:To examine the effect of carbamazepine and valproate monotherapy on bone blood serum metabolism index and hormone in adult.Method: In the present study, 30 adult patients aged 18～40 with epilepsy and treated with VPA alone for over 6 months were recruited.Subjects for comparison consisted of two groups:30 age-matched adults with epilepsy taking CBZ as monotherapy for more than 6 months; and 50 community-dwelling, sex-matched volunteers of the same age-range serving as controls. Serum concentrations of calcium(Ca 2+)、 phosphate (P 3+),alkaline phosphatase (ALP),intact parathyroid hormone(iPTH),Calcitonin(CT) and 25 hydroxy-vitamin D[25-(OH)D] were examined in all patients and controls.Results:Carbamazepine group and Valproate group were compared with the control group for concentration of Ca 2+,P 3+ ,ALP.Serum concentrations of Ca 2+,P 3+ and 25-(OH)D were significantly lower with CBZ than control group, serum concentrations of Ca 2+ and 25-(OH)D in patients with VPA were significantly higher than those with CBZ and control groups. Serum concentrations of ALP,iPTH and CT were higher with both CBZ and VPA than control, implying that higher turnover and increased bone resorption caused by either drug. Conclusion: CBZ and VPA have different mechanisms affecting bone metabolism.
出处
《广州医学院学报》
2004年第3期37-39,共3页
Academic Journal of Guangzhou Medical College
基金
广东省卫生厅基金[WSTJJ2 0 0 2 1113430 10 5 196 312 2 6 30 5 0 (A316 ) ]
关键词
癫痫
抗癫痫药
钙
epilepsy
antiepileptic drug
calcium
