丙戊酸对癫痫患儿骨代谢的影响

The effect of valproate on bone metabolism in children with epilepsy

目的:研究丙戊酸对癫痫患者骨代谢的影响。方法:癫痫患者组34例于丙戊酸治疗前、治疗后3个月及6个月分别测定血钙(Ca)、血磷(P)、骨性碱性磷酸酶(BAP)、骨钙素(BGP)、甲状旁腺素(PTH)、1,25-二羟维生素D3[1,25-(OH)2VitD3]、降钙素(CT)及尿脱氧吡啶啉(DPD)、肌酐(Cr);并设正常对照组30例。结果:两组治疗前骨代谢无显著差异;治疗组治疗后3个月、6个月CT、BAP、BGP、DPD、Cr均较治疗前明显升高(P<0.05),1,25-(OH)2VitD3较治疗前明显下降(P<0.05)。结论:丙戊酸治疗癫痫患儿可致骨代谢异常,骨形成及骨吸收均明显活跃。

Objective： To study the effect of valproate on bone metabolism in children with epilepsy. Methods： Calcium （Ca）, phosphorum （P）, bone alkaline phosphate （BAP）, bone carboxyglutamate protein （BGP）, parathormone （PTH）, 1,25-（OH）2VitD3, calcitonin （CT） in serum and deoxypyridinoline （DPD）, creatinine （Cr） in urine were measured in 34 epilepsy children treated with valproate before and 3 or 6 months after the treatment, so did in the control group of 30 healthy children. Results： There was no significant difference in bone metabolism between the therapy and the control group before the treatment. Ca, P and PTH serums levels showed no significant changes 3 or 6 months after the treatment while the CT, BAP, BGP, DPD,Cr were higher and 1,25-（OH）2VitD3 serum levels were lower than that be fore the treatment（P 〈 0.05）. Conclusion： Valproate treatment in epileply activates bone resorption and bone formation, which lead to abnormal bone metabolism.