双膦酸盐对癫痫病人骨质疏松及骨折风险保护作用研究

Preventive effect of bisphosphonate against osteoporosis and bone fractures in epilepsy patients

目的观察双膦酸盐对癫痫病人骨质疏松及骨折风险的保护作用。方法选择2015年6月至2016年6月于我院神经内科、神经外科就诊的癫痫病人112例,采用随机数字表法将病人分为两组:双膦酸盐组55例,给予口服阿仑膦酸钠+碳酸钙/维生素D_3,对照组57例,仅给予碳酸钙/维生素D3。测量治疗前后两组病人血清25-羟基维生素D水平、腰椎及股骨上段骨密度值,并统计骨折情况进行保护效应分析。结果随访1年,双膦酸盐组的血清25-羟基维生素D水平、股骨上段骨密度值分别为(27.94±7.97)μg/L、(0.95±0.12)g/cm^2,对照组分别为(27.84±7.45)μg/L、(0.91±0.11)g/cm^2,差异均无统计学意义(P均>0.05);双膦酸盐组及对照组腰椎骨密度值分别为(1.16±0.12)g/cm2、(1.06±0.13)g/cm^2,差异具有统计学意义(P<0.01);对照组病人发生骨折6例(10.53%),双膦酸盐组中无病人发生骨折,两组间差异具有统计学意义(P<0.05);两组病人的不良反应发生率比较,差异无统计学意义(P>0.05)。结论双膦酸盐能够安全有效地改善癫痫病人骨质疏松状态,并且可以预防癫痫病人骨折的发生。

Objective To observe the effectiveness of bisphosphonate in anti-osteoporosis and prevention against bone fracture of epilepsy patients.Methods According to the inclusion and exclusion criteria,112patients with epilepsy on neurology or neurosurgery clinic from June2015to June2016were enrolled,and randomly divided into treatment group(n=55)and control group(n=57).The treatment group received alendronate combined with calcium carbonate and vitamin D3tablets,and the control group was given pure calcium carbonate and vitamin D3tablets.The visual analog scale of pain,numbness,and straight leg raising test were used for efficacy analysis,and adverse reactions were observed during the treatment.The level of serum25-hydroxy vitamin D,the total bone mineral density(BMD)of the first to the fourth lumbar vertebrae and the proximal of left femur,and the incidence of new bone fractures were monitored and analyzed.Results After one year of treatment,the25-hydroxy vitamin D levels,and total BMD of proximal femur in the treatment group and control group were(27.94±7.97)μg/L vs.(27.84±7.45)μg/L and(0.95±0.12)g/cm2vs.(0.91±0.11)g/cm2respectively,with the difference being not statistically significant(P>0.05).The total BMD of lumbar vertebrae in the treatment group[(1.16±0.12)g/cm2]was significantly increased compared to the control group[(1.06±0.13)g/cm2](P<0.01).Bone fracture occurred in6patients(10.53%)of the control group,and none in the treatment group.The adverse reactions incidence in the control and treatment groups was12.28%and14.55%respectively(P>0.05).Conclusion Bisphosphonate performs anti?osteoporosis effect in epileptic patients safely and effectively,and it also can prevent the bone fractures of epileptic patients.