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目的观察丙戊酸对癫痫儿童骨密度的影响及VitD的预防作用。方法 6-14岁癫痫儿童63例,分两组,一组以单药丙戊酸治疗,另一组以丙戊酸+VitD治疗,应用CT分别测量两组治疗前及治疗后6个月第四腰椎及股骨颈骨密质和骨松质的骨密度值。结果丙戊酸治疗组和丙戊酸+VitD治疗组治疗前骨松质、骨密质的骨密度无明显差异。在第4腰椎和股骨颈,丙戊酸治疗组疗后6个月骨松质的骨密度明显低于疗前,差异有明显意义;丙戊酸+VitD治疗组疗后6个月骨松质的骨密度与治疗前无明显差异。丙戊酸+VitD治疗组治疗6个月后第四腰椎骨松质的骨密度变化率显著低于丙戊酸治疗组,添加VitD能提高骨松质的骨密度。结论丙戊酸可致癫痫儿童的骨松质密度明显降低。VitD对此副作用有预防作用。
Objective To observe the effect of valproic acid on bone mineral density in children with epilepsy and the preventive effect of VitD. Methods Sixty-three children with epilepsy aged 6-14 years were divided into two groups: one was treated with valproic acid alone and the other was treated with valproic acid + VitD. CT was used to measure the difference between the two groups before and 6 months after treatment Four lumbar and femoral neck bone and bone cancellous bone mineral density value. Results There were no significant differences in bone mineral density between the valproic acid group and valproate + VitD group before treatment. In the 4th lumbar and femoral neck, the bone mineral density of osteoporosis was significantly lower 6 months after valproic acid treatment than that before treatment, the difference was significant; valproic acid + VitD treatment group 6 months after treatment, The bone mineral density and no significant difference before treatment. Valproic acid + VitD treatment group after 6 months of treatment the fourth lumbar spine cancellous bone mineral density was significantly lower than valproic acid treatment group, adding VitD can increase bone mineral density of spongy bone. Conclusions The bone density of children with epilepsy induced by valproic acid is obviously decreased. VitD can prevent this side effect.