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抗癫痫药与骨病

Authors
Alison M Pack, MD
Elizabeth Shane, MD
Section Editors
Timothy A Pedley, MD
Marc K Drezner, MD
Deputy Editor
Jean E Mulder, MD
Translators
韩雄, 主任医师

引言

癫痫是一种慢性疾病，美国的患者超过200万人(约为人口总数的1%)[1]。抗癫痫药(antiepileptic drug, AED)一直是癫痫的主要治疗方法。此外，这些药物现在有了多种其他适应证，包括治疗偏头痛、双相障碍和慢性疼痛。

癫痫和AED均会对骨骼健康产生不良影响。在接受AED治疗的癫痫患者中，骨丢失和骨与矿物质代谢异常的发生率增加[2,3]。这些不良作用可能增加骨折的风险[4-7]。

本专题将总结AED和骨与矿物质代谢疾病的关系，后者包括骨软化症/佝偻病和骨质疏松或骨量减少；此外，也将讨论AED相关性骨病的筛查、治疗和预防。

癫痫的治疗和AED的药理学将在别处讨论。 (参见“成人癫痫处理概述”和“成人癫痫的初始治疗”和“抗癫痫发作药物的作用机制、药理作用及不良反应”)

代谢性骨病

首次将AED治疗与骨骼疾病联系在一起的报道，发表于20世纪60年代晚期[8]。受累患者存在明显的骨病，其临床、生化和组织学异常与佝偻病和骨软化症一致。 然而，这些早期报道的对象大多为居住于医疗机构的患者。

                   

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Literature review current through: 2017-06 . | This topic last updated: 2017-01-09.
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