Erbayat Altay E, Serdaroğlu A, Tümer L, Gücüyener K, Hasanoğlu A
Department of Pediatric Neurology, Medical Faculty, Gazi University, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2000 Jul-Aug;13(7):933-9. doi: 10.1515/jpem.2000.13.7.933.
Dual energy X-ray absorptiometry (DXA) was used to assess lumbar spine (L2-4) and femoral neck bone mineral density (BMD) in 36 children taking either carbamazepine or valproic acid for longer than one year, for generalized idiopathic epilepsy. Patients were matched with controls. Biochemical parameters of bone mineral metabolism were also measured. BMD values at both the femur neck and lumbar spine in both the carbamazepine and valproic acid groups were not significantly different from that of the control group. Serum levels of calcium were subnormal and alkaline phosphatase levels were high in the carbamazepine group. Urinary calcium levels were significantly lower in both groups than in the control group (p< or =0.05) and also significantly lower in the valproic acid group than in the carbamazepine group (p< or = 0.05). There were no other significant biochemical changes in either group. In conclusion, the results suggest that valproic acid and carbamazepine monotherapies have minimal effects on bone mineral metabolism, but routine monitoring of risk and consideration of prophylactic vitamin D supplementation is important.
采用双能X线吸收法（DXA）对36例因全身性特发性癫痫服用卡马西平或丙戊酸超过一年的儿童进行腰椎（L2 - 4）和股骨颈骨密度（BMD）评估。患者与对照组进行匹配。同时还测量了骨矿物质代谢的生化参数。卡马西平组和丙戊酸组的股骨颈和腰椎BMD值与对照组相比无显著差异。卡马西平组血清钙水平低于正常，碱性磷酸酶水平升高。两组尿钙水平均显著低于对照组（p≤0.05），且丙戊酸组尿钙水平显著低于卡马西平组（p≤0.05）。两组均无其他显著的生化变化。总之，结果表明丙戊酸和卡马西平单药治疗对骨矿物质代谢影响极小，但常规监测风险并考虑预防性补充维生素D很重要。
