抗癫(癇)药物长期应用与儿童代谢性骨病.pdfVIP

·综述· 抗癫痫药物长期应用与儿童代谢性骨病 王千(综述)郝艳秋(审校) 【摘要】 癫痫是儿童常见的慢性脑功能障碍性疾病。研究表明抗癫痫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。由于抗癫痫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痫药物治疗的同时，应用维生素D、钙剂及运动 锻炼可预防代谢性骨病的发生。 【关键词】抗癫疴药物；儿童代谢性骨病 disasein andmetabolicbone children眦州G Long-termanti-epilepticdrugtherapy Q洳，HAOYon·qiu． Second DepartmentofPediatrics．theAffiliatedHospitalofHarb胁MedicalUniversity。胁而拥j5D086。China isacommonchronicbrain inchildren．Studieshaveshowedthat 【Abstractl Epilepsy dysfunction antiepi— ofvitaminin and andinhibitthe of the D fiver calcificationbone， lepticdrugs(AED)affecthydroxylation kidney by oxidaseP450and theresolutionofvitamin then mainlyup．regulatingcytochrome promoting D。and increasing sertlin hormone USe啪causechildrenmetabolicbonediseaseoocun．ence． parathyroidcompensatory．Long-term include affectthe clinicalmanifestationsbone statum．rickets．teeth pain。short agencsis．fracture。etc．AEDfirstly that tests hormonesrelatedtobonemetabolismin the researchesfocusonbiochemicalandmeas- vivo．SO present urementofsclerotinandbone thechildren，s useof treatmentatthesame density．In long．term antiepflepticdrug andexercisecall theoccurrenccofmetabolicbonedisease． time．the ofVitaminD．calcium application prevent