丙戊酸对癫痫儿童骨密度的影响及VitD防治作用

Effects of valproate and Vitamin D Replacement on bone mineral density in epileptic children.

目的观察丙戊酸对癫痫儿童骨密度的影响及VitD的预防作用。方法 6-14岁癫痫儿童63例,分两组,一组以单药丙戊酸治疗,另一组以丙戊酸+VitD治疗,应用CT分别测量两组治疗前及治疗后6个月第四腰椎及股骨颈骨密质和骨松质的骨密度值。结果丙戊酸治疗组和丙戊酸+VitD治疗组治疗前骨松质、骨密质的骨密度无明显差异。在第4腰椎和股骨颈,丙戊酸治疗组疗后6个月骨松质的骨密度明显低于疗前,差异有明显意义;丙戊酸+VitD治疗组疗后6个月骨松质的骨密度与治疗前无明显差异。丙戊酸+VitD治疗组治疗6个月后第四腰椎骨松质的骨密度变化率显著低于丙戊酸治疗组,添加VitD能提高骨松质的骨密度。结论丙戊酸可致癫痫儿童的骨松质密度明显降低。VitD对此副作用有预防作用。

Objective： it is to investigate the effects of valproate on bone mineral density in epileptic children and the preventive effect of vitamin D replacement therapy.Methods： 63 cases of epilepsy between 6-14 years old were divided into valproate group,which received single valproate therapy,and valproate plus VitD group,which were treated with valproate and Vitamin D.And both the cancellous and the compact bone mineral density in fourth lumbar vertebra and collum femoris were determined with CT before and after 6 month＇s therapy.Results： before the therapy,there is no significant difference in bone mineral density between two groups.After the 6-month therapy,the cancellous bone mineral density in fourth lumbar vertebra and collum femoris were significantly decreased in valproate group,but not in valproate plus VitD group;the Percentage of changes in the cancellous bone mineral density of fourth lumbar vertebra in valproate plus VitD group were significantly lower than that in valproate group,indicating Vitamin D Replacement increased the cancellous bone mineral density.Conclusions： valproic therapy could reduce the cancellous bone mineral density in epileptic children,and Vitamin D Replacement can prevent this adverse effect.