Pack Alison M.
Epilepsy Curr. 2003 May;3(3):91-95. doi: 10.1046/j.1535-7597.2003.03306.x.
A growing body of literature indicates an association between antiepileptic drugs (AEDs) and bone disease, including histologic, radiographic, and biochemical evidence. The AEDs most commonly reported to cause decreased bone mineral density and disorders of bone metabolism are inducers of the cytochrome P450 enzyme system (phenobarbital, phenytoin, carbamazepine, primidone). More recent studies also suggest that valproate, an enzyme inhibitor, causes abnormalities in bone health. Multiple mechanisms have been postulated to support the association; however, no single mechanism explains all the findings. Identifying bone disease in persons with epilepsy receiving AEDs is important, as multiple treatment options are available.
越来越多的文献表明抗癫痫药物(AEDs)与骨病之间存在关联,包括组织学、影像学和生物化学证据。最常被报道会导致骨密度降低和骨代谢紊乱的AEDs是细胞色素P450酶系统的诱导剂(苯巴比妥、苯妥英、卡马西平、扑米酮)。最近的研究还表明,作为酶抑制剂的丙戊酸盐会导致骨骼健康异常。人们提出了多种机制来支持这种关联;然而,没有一种单一的机制能够解释所有的研究结果。识别正在接受AEDs治疗的癫痫患者的骨病很重要,因为有多种治疗选择。