托吡酯和卡马西平对癫癎患儿骨代谢的影响

Effect of topiramate and carbamazepine on bone metabolism in children with epilepsy

摘要:

目的：探讨抗癫癎药托吡酯(topiramate,TPM)和卡马西平(carbamazepine,CBZ)对癫癎患儿骨代谢的影响。方法：对63例单独服用TPM和CBZ的癫癎患儿及36例未用药物治疗的癫癎患儿（对照组）进行血钙、磷、碱性磷酸酶和骨密度的测定。结果：TPM组血钙浓度2.41±0.17 mmol/L,较对照组的2.26±0.11 mmol/L高，CBZ组2.15±0.26 mmol/L，较对照组低（均P<0.05）。TPM组与CBZ组血磷浓度分别为1.55±0.17 和1.52±0.26 mmol/L，对照组为1.70±0.30 mmol/L，TPM组与CBZ组均较对照组低（P<0.05）。血碱性磷酸酶各组间差异无显著性（P>0.05）。与对照组比较，TPM和CBZ组患儿均有不同程度的骨密度降低(P<0.05)。结论：托吡酯和卡马西平均可引起血钙、磷的异常变化和骨密度的降低。［中国当代儿科杂志，2010，12（2）：96-98］

Abstract:

OBJECTIVE: To assess bone health in epileptic children who have been treated with topiramate (TPM) or carbamazepine (CBZ). METHODS: Sixty-three epileptic children who received TPM or CBZ treatment and 36 eileptic children who did not receive any drug treatment (control group) were enrolled. Bone mineral density (BMD) at lumbar vertebrae (L1-L4) and radius-ulna was evaluated by the dual-energy X-ray absorptiometry method. Biochemical indices of bone metabolism, including serum calcium, phosphorus and alkaline phosphatase contents were measured. RESULTS: The serum calcium content was higher in the TPM group (2.41±0.17 mmol/L), but it was lower in the CBZ group (2.15±0.26 mmol/L) than that (2.26±0.11 mmol/L) in the control group (P<0.05). The serum phosphorus content in both the TPM (1.55±0.17 mmol/L) and the CBZ groups (1.52±0.26 mmol/L) was significantly lower than that in the control group (1.70±0.30 mmol/L) (P<0.05). There were no significant differences in the serum content of alkaline phosphatase between three groups. BMD was significantly reduced in both the TPM and the CBZ groups when compared to the control group (P<0.05). CONCLUSIONS: TPM and CBZ may result in alterations in serum contents of calcium, phosphorus and alkaline phosphatase as well as BMD reduction.［Chin J Contemp Pediatr, 2010, 12 (2):96-98］