抗癲癇藥物與骨折風險_Journal of Epilepsy

Authors：

冉俊哲 ¹ ,  慕潔 ²

1. ;
2. ;

Corresponding?author：

慕潔, Email: mujie2010@foxmail.com

Keywords：

抗癲癇藥物; 骨折; 骨密度

DOI：

10.7507/2096-0247.20170062

Video：

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Abstract Full text Figures/Tables Video References Cited by

癲癇是神經系統的一種常見疾病，藥物治療是癲癇治療的首選方法。由于癲癇病程長，患者常常需要長期服藥甚至終身服藥，藥物長期服用的安全性是必須考慮的。有研究顯示癲癇患者的骨折風險是普通人群的2~6倍，長期服用抗癲癇藥物(AEDs)是導致骨折風險增加的獨立危險因素。不同類型的AEDs對不同年齡階段人群的骨代謝有不同的影響，應根據不同年齡選擇合適的藥物。如何預防骨折是癲癇專科醫生應該關心的問題，應注意監測相關指標，防止骨折的發生。

Citation： 冉俊哲, 慕潔. 抗癲癇藥物與骨折風險. Journal of Epilepsy, 2017, 3(5): 401-405. doi: 10.7507/2096-0247.20170062 Copy

1.	王文志, 吳建中, 戴秀英, 等.我國五省農村地區開展人群干預后癲癇治療缺口的變化.中華神經科雜志, 2007, 40(6): 387-390.
2.	Pack AM. Treatment of epilepsy to optimize bone health.Curr Treat Options Neurol. 2011, 13(4): 346-354.
3.	Tsiropoulos I, Andersen M, Nymark T, et al. Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study.Epilepsia, 2008, 49(12): 2092-2099.
4.	Shiek Ahmad B, Hill KD, O'Brien TJ, et al. Falls and fractures in patients chronically treated with antiepileptic drugs. Neurology, 2012, 79(2): 145-151.
5.	Kubota F, Kifune A, Shibata N, et al. Bone mineral density of epileptic patients on long-term antiepileptic drug therapy: a quantitative digital radiography study. Epilepsy Res, 1999, 33(2-3): 93-97.
6.	Zhang Y, Zheng Y, Zhu J, et al. Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: a meta-analysis. J Zhejiang Univ Sci B, 2015, 16(7): 611-621.
7.	El-Hajj Fuleihan G, Dib L, Yamout B, et al. Predictors of bone density in ambulatory patients on antiepileptic drugs. Bone, 2008, 43(1): 149-155.
8.	Lee HS, Wang SY, Salter DM, et al.The impact of the use of antiepileptic drugs on the growth of children. BMC Pediatr, 2013, 13: 211.
9.	van Staa TP, Leufkens HG, Cooper C. Utility of medical and drug history in fracture risk prediction among men and women. Bone, 2002, 31(4): 508-514.
10.	Shiek Ahmad B, Hill KD, O'Brien TJ, et al. Falls and fractures in patients chronically treated with antiepileptic drug. Neurology, 2012, 79(2): 145-151.
11.	Bjorholt PG, Nakken KO, Rohme K, et al. Leisure time habits and physical fitness in adults with epilepsy.Epilepsia, 1990, 31(1): 83-87.
12.	Petty SJ, Paton LM, O'Brien TJ, et al. Effect of antiepileptic medication on bone mineral measures. Neurology, 2005, 65(9): 1358-1365.
13.	Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system-active medications and risk for falls in older women. J Am Geriatr Soc, 2002, 50(10): 1629-1637.
14.	Perucca E. Clinical implications of hepatic microsomal enzyme induction by antiepileptic drugs.PharmacolTher, 1987, 33(1): 139-144.
15.	段春波, 金世鑫.降鈣素受體基因多態性與骨質疏松表型的研究進展.中國老年學雜志, 2005, 25(7): 867-869.
16.	許莉, 張金環, 許前.拉莫三嗪、卡馬西平及丙戊酸對癲癇患兒的骨質影響.中國實用醫藥, 2011, 06(11): 166-167.
17.	吳丹紅, 李承晏.抗癲癇藥對癲癇患者骨代謝的影響.武漢大學學報(醫學版), 2004, 25(3): 318-320.
18.	Nissen-Meyer LSH, Svalheim S, Tauboll E, et al. Levetiracetam, phenytoin, and valproate act differently on rat bone mass, structure, and metabolism. Epilepsia, 2007, 48(10): 1850-1860.
19.	Feldkamp J, Becker A, Witte OW, et al. Long-term anticonvulsant therapy leads to low bone mineral density-evidence for direct drug effects of phenytoin and carbamazepine on human osteoblast-like cells. Exp Clin Endocrinol Diabetes, 2000, 108(1): 37-43.
20.	鹿梁燕, 黃志凌.丙戊酸鈉對成年癲癇患者骨代謝的影響.長治醫學院學報, 2012, 26(04): 265-267.
21.	Gunes A, Bilir E, Zengil H, et al. Inhibitory effect of valproic acid on cytochrome P4502C9 activity in epilepsy patients. Basic Clin Pharmacol Toxicol, 2007, 100(6): 383-386.
22.	Humphrey EL, Morris GE, Fuller HR. Valproate reduces collagen and osteonectin in cultured bone cells. Epilepsy Res, 2013, 106(3): 446-450.
23.	Sheth RD, Hermann BP. Bone mineral density with lamotrigine monotherapy for epilepsy. Pediatr Neurol, 2007, 37(4): 250-254.
24.	Heo K, Rhee Y, Lee HW, et al. The effect of topiramate monotherapy on bone mineral density and markers of bone and mineral metabolism in premenopausal women with epilepsy.Epilepsia, 2011, 52(10): 1884-1889.
25.	Pack A. Levetiracetamtreatment does not result in broken bones. Epilepsy Curr, 2013, 13(2): 83-84.
26.	Andress DL, Ozuna J, Tirschwell D, et al. Antiepileptic drug-induced bone loss in young male patients who have seizures. Arch Neurol, 2002, 59(5): 781-786.
27.	Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system-active medications and risk for fractures in older women. Arch Intern Med, 2003, 163(8): 949-957.
28.	Ensrud KE, Walczak TS, Blackwell T, et al. Antiepileptic drug use increases rates of bone loss in older women: a prospective study. Neurology, 2004, 62(11): 2051-2057.
29.	Lambrinoudaki I, Kaparos G, Armeni E, et al. BsmI Vitamin D receptors polymorphism and bone mineral density in men and premenopausal women on long-term antiepileptic therapy. Eur J Neurol, 2010, 18(1): 93-98.

1. 王文志, 吳建中, 戴秀英, 等.我國五省農村地區開展人群干預后癲癇治療缺口的變化.中華神經科雜志, 2007, 40(6): 387-390.
2. Pack AM. Treatment of epilepsy to optimize bone health.Curr Treat Options Neurol. 2011, 13(4): 346-354.
3. Tsiropoulos I, Andersen M, Nymark T, et al. Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study.Epilepsia, 2008, 49(12): 2092-2099.
4. Shiek Ahmad B, Hill KD, O'Brien TJ, et al. Falls and fractures in patients chronically treated with antiepileptic drugs. Neurology, 2012, 79(2): 145-151.
5. Kubota F, Kifune A, Shibata N, et al. Bone mineral density of epileptic patients on long-term antiepileptic drug therapy: a quantitative digital radiography study. Epilepsy Res, 1999, 33(2-3): 93-97.
6. Zhang Y, Zheng Y, Zhu J, et al. Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: a meta-analysis. J Zhejiang Univ Sci B, 2015, 16(7): 611-621.
7. El-Hajj Fuleihan G, Dib L, Yamout B, et al. Predictors of bone density in ambulatory patients on antiepileptic drugs. Bone, 2008, 43(1): 149-155.
8. Lee HS, Wang SY, Salter DM, et al.The impact of the use of antiepileptic drugs on the growth of children. BMC Pediatr, 2013, 13: 211.
9. van Staa TP, Leufkens HG, Cooper C. Utility of medical and drug history in fracture risk prediction among men and women. Bone, 2002, 31(4): 508-514.
10. Shiek Ahmad B, Hill KD, O'Brien TJ, et al. Falls and fractures in patients chronically treated with antiepileptic drug. Neurology, 2012, 79(2): 145-151.
11. Bjorholt PG, Nakken KO, Rohme K, et al. Leisure time habits and physical fitness in adults with epilepsy.Epilepsia, 1990, 31(1): 83-87.
12. Petty SJ, Paton LM, O'Brien TJ, et al. Effect of antiepileptic medication on bone mineral measures. Neurology, 2005, 65(9): 1358-1365.
13. Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system-active medications and risk for falls in older women. J Am Geriatr Soc, 2002, 50(10): 1629-1637.
14. Perucca E. Clinical implications of hepatic microsomal enzyme induction by antiepileptic drugs.PharmacolTher, 1987, 33(1): 139-144.
15. 段春波, 金世鑫.降鈣素受體基因多態性與骨質疏松表型的研究進展.中國老年學雜志, 2005, 25(7): 867-869.
16. 許莉, 張金環, 許前.拉莫三嗪、卡馬西平及丙戊酸對癲癇患兒的骨質影響.中國實用醫藥, 2011, 06(11): 166-167.
17. 吳丹紅, 李承晏.抗癲癇藥對癲癇患者骨代謝的影響.武漢大學學報(醫學版), 2004, 25(3): 318-320.
18. Nissen-Meyer LSH, Svalheim S, Tauboll E, et al. Levetiracetam, phenytoin, and valproate act differently on rat bone mass, structure, and metabolism. Epilepsia, 2007, 48(10): 1850-1860.
19. Feldkamp J, Becker A, Witte OW, et al. Long-term anticonvulsant therapy leads to low bone mineral density-evidence for direct drug effects of phenytoin and carbamazepine on human osteoblast-like cells. Exp Clin Endocrinol Diabetes, 2000, 108(1): 37-43.
20. 鹿梁燕, 黃志凌.丙戊酸鈉對成年癲癇患者骨代謝的影響.長治醫學院學報, 2012, 26(04): 265-267.
21. Gunes A, Bilir E, Zengil H, et al. Inhibitory effect of valproic acid on cytochrome P4502C9 activity in epilepsy patients. Basic Clin Pharmacol Toxicol, 2007, 100(6): 383-386.
22. Humphrey EL, Morris GE, Fuller HR. Valproate reduces collagen and osteonectin in cultured bone cells. Epilepsy Res, 2013, 106(3): 446-450.
23. Sheth RD, Hermann BP. Bone mineral density with lamotrigine monotherapy for epilepsy. Pediatr Neurol, 2007, 37(4): 250-254.
24. Heo K, Rhee Y, Lee HW, et al. The effect of topiramate monotherapy on bone mineral density and markers of bone and mineral metabolism in premenopausal women with epilepsy.Epilepsia, 2011, 52(10): 1884-1889.
25. Pack A. Levetiracetamtreatment does not result in broken bones. Epilepsy Curr, 2013, 13(2): 83-84.
26. Andress DL, Ozuna J, Tirschwell D, et al. Antiepileptic drug-induced bone loss in young male patients who have seizures. Arch Neurol, 2002, 59(5): 781-786.
27. Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system-active medications and risk for fractures in older women. Arch Intern Med, 2003, 163(8): 949-957.
28. Ensrud KE, Walczak TS, Blackwell T, et al. Antiepileptic drug use increases rates of bone loss in older women: a prospective study. Neurology, 2004, 62(11): 2051-2057.
29. Lambrinoudaki I, Kaparos G, Armeni E, et al. BsmI Vitamin D receptors polymorphism and bone mineral density in men and premenopausal women on long-term antiepileptic therapy. Eur J Neurol, 2010, 18(1): 93-98.

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