长期服苯妥英钠癫痫患者的骨代谢研究

THE BONE METABOLISM IN EPILEPTIC PATIENTS ON LONG-TERM TREATMENT WITH PHENYTOIN

本工作测定了20例长期服苯妥英钠的癫痫患者血DPH、25OH D_3、cAMP、Ca、P、AKP、离子钙;尿cAMP、Ca、P及羟脯氨酸水平;桡、尺骨骨矿物含量和骨密度,并设立相应健康人作为对照组。测定结果为:癫痫组25OHD_3水平显著低于对照;全部患者中血钙降低者占20％;血磷降低者低占25％;尿钙、磷降低者占45％和55％;血离子钙降低者占85％;AKP和尿羟脯氨酸升高各占10％。癫痫组桡骨骨矿物含量、骨密度及尺骨的骨密度值显著低于对照组。

Twenty epileptic patients on long-term treatment with phenytoin (DPH) were tested for blood DPH, 25(OH)D3, cAMP, Ca, P, AKP, ionized Ca and urinary cAMP, Ca, P, hydroxyproline (Hyp) levels. At the same time the bone mineral contents and bone densities of radius and ulna were also measured. 20 healthy subjects were performed as controls. The results showed that the levels of serum 25(OH)D, were significantly lower in the epileptics than in the controls. Decreased serum Ca and P contents were observed in 20% and 25% of the epileptics respectively, whereas a respective 45% and 55% showed lowered urinary Ca and P. Serum ionized Ca decreased in 85% of the epileptics and serum AKP and urinary Hyp increased/in 10% of the epileptics. Comparison with an age-sex-body weight-matched group of the controls showed that the bone mineral contents and the bone densities of the radius and the ulna were significantly lower in the epileptics than in the controls.