Silver J, Davies T J, Kupersmitt E, Orme M, Petrie A, Vajda F
Arch Dis Child. 1974 May;49(5):344-50. doi: 10.1136/adc.49.5.344.
Bone metabolism was studied in a group of adolescent epileptic children given anticonvulsant drugs and compared with a matched group of nonepileptic children living in the same institutional environment. Biochemical evidence of vitamin D deficiency was more common in treated children than in controls, and 3 out of 60 children taking anticonvulsants had radiological evidence of rickets. The signs of vitamin D deficiency could not be corrected by giving 5 μg (200 IU) cholecalciferol daily for 12 weeks, but disappeared after treatment with 75 μg (3000 IU) cholecalciferol weekly for a further 12 weeks. Thus, in a residential home in southeast England the increased nutritional requirement for vitamin D caused by the administration of anticonvulsants to adolescent epileptic children was of the order of 10 μg cholecalciferol per day. It is likely that all epileptic subjects on anticonvulsants have increased needs for vitamin D and we advise regular supplementation of their diets. It is also shown that serum concentrations of γ-glutamyl transpeptidase, 5′nucleotidase, and leucine aminopeptidase are raised in children taking anticonvulsants. It seems likely that this is caused by drug induction of membrane-bound enzymes in the liver.
对一组服用抗惊厥药物的青春期癫痫儿童的骨代谢进行了研究，并与生活在相同机构环境中的一组匹配的非癫痫儿童进行了比较。接受治疗的儿童中维生素D缺乏的生化证据比对照组更为常见，60名服用抗惊厥药的儿童中有3名有佝偻病的放射学证据。每天给予5μg（200IU）胆钙化醇，持续12周，无法纠正维生素D缺乏的体征，但在随后12周每周给予75μg（3000IU）胆钙化醇治疗后体征消失。因此，在英格兰东南部的一家福利院中，青春期癫痫儿童服用抗惊厥药导致的维生素D营养需求增加约为每天10μg胆钙化醇。所有服用抗惊厥药的癫痫患者对维生素D的需求可能都会增加，我们建议定期补充他们的饮食。研究还表明，服用抗惊厥药的儿童血清γ-谷氨酰转肽酶、5'-核苷酸酶和亮氨酸氨肽酶的浓度会升高。这似乎是由药物诱导肝脏中的膜结合酶所致。
