抗癫痫药物长期应用与儿童代谢性骨病

Long-term anti-epileptic drug therapy and metabolic bone disase in children

癫痫是儿童常见的慢性脑功能障碍性疾病。研究表明抗癫疴药物主要通过影响细胞色素氧化酶P450的上调，促进维生素D的分解，继发代偿性的血清甲状旁腺激素水平增高，影响维生素D在肝肾的羟化，骨钙化受阻。长期应用可导致儿童代谢性骨病的发生，临床表现为骨痛、身材矮小、佝偻病、牙齿发育不全、骨折等。由于抗癫疴药物首先影响体内与骨代谢相关的激素，目前研究多集中在相关生物化学检查及骨质或骨密度测量等方面。在对儿童长期应用抗癫疴药物治疗的同时，应用维生素D、钙剂及运动锻炼可预防代谢性骨病的发生。

Epilepsy is a common chronic brain dysfunction in children. Studies have showed that antiepi- leptic drugs （AED） affect the hydroxylation of vitamin D in liver and kidney and inhibit the calcification of bone, mainly by up-regulating cytochrome oxidase P450 and promoting the resolution of vitamin D, and then increasing serum parathyroid hormone compensatory. Long-term use can cause children metabolic bone disease occurrence, clinical manifestations include bone pain, short stature, rickets, teeth agenesis, fracture, etc. AED firstly affect the hormones related to bone metabolism in vivo,so that the present researches focus on biochemical tests and meas- urement of sclerotin and bone density. In the children＇s long-term use of antiepileptic drug treatment at the same time,the application of Vitamin D,calcium and exercise can prevent the occurrence of metabolic bone disease.