抗癫痫药物对癫痫患儿的骨代谢影响研究

目的分析抗癫痫药物对癫痫患儿骨代谢相关指标及生活质量的影响。方法选取2013年1月至2015年2月在我院接受抗癫痫药物治疗的癫痫患儿42例为观察组,另选取同时期未接受癫痫药物治疗的癫痫患儿36例为对照组,对比两组患儿治疗前后血清碱性磷酸酶(ALP)、血钙(Ca~(2+))、血磷(P)、骨密度(BMD)、磷酸酶(BAP)等骨代谢相关指标,并应用生活质量评估量表(QOLIE-31)对治疗前后两组患儿的生活质量进行评价。结果治疗后,观察组患儿的Ca~(2+)水平显著降低,BAP水平显著升高,差异均有统计学意义(P<0.05),ALP、P及BMD均无显著变化(P>0.05);观察组患儿的Ca2+水平低于对照组,BAP水平显著高于对照组,差异有统计学意义(P<0.05);对照组患儿各项骨代谢指标无显著变化(P>0.05)。治疗前,两组患儿的生活质量评分比较差异无统计学意义(P>0.05),治疗后,观察组患儿生活质量评分升高,且高于对照组,差异均有统计学意义(P<0.05)。结论抗癫痫药物能够提高癫痫患儿的生活质量,其对癫痫患儿的骨代谢具有一定的影响,对BAP的影响最显著。BAP可以作为指导正确应用癫痫药物的指标。     

抗癫痫药对成人骨代谢的影响及药学监护

目的:探讨抗癫痫药对成人骨代谢的影响及癫痫合并骨质疏松患者药学监护。方法:对1例癫痫合并严重骨质疏松患者的病例进行分析,探讨抗癫痫药对该患者骨代谢的影响及该患者骨质疏松的治疗。结果:对患者进行药学评估,认为患者严重骨质疏松与长期使用抗癫痫药丙戊酸钠有关,并对患者进行维生素D、钙剂补充及双膦酸盐治疗。结论:对于长期使用抗癫痫药的患者进行骨代谢相关指标监测及药学评估,适时的进行药学干预可预防及降低患者严重骨质疏松及骨折发生风险。     

抗癫痫药物对骨骼的影响

本文报导了70例癫痫患儿的血钙、磷、碱性磷酸酶(下简称AKP)改变的观察。对部分患儿并作了腕骨X线摄片。这些患儿年龄在2 1/2～12岁之间,服抗癫痫药达半年以上,癫痫控制的效果较好,他们否认肝炎史,无肝脾肿大现象,营养情况较好,肝功能检查均正常。在70例中AKP增高(大于30金氏单位),并有钙、磷改变者28例;AKP正常但磷低、钙磷乘积不足40者3例。二者共占总数的44.4％。对照组10例中仅1例AKP稍增高。以上变化可能由于药物对肝酶的诱导作用,促     

抗癫痫药物对儿童生长发育的影响

癫痫是神经内科一种常见慢性疾病,由许多不明病因引起脑部神经元高度同步化而异常放电所致的中枢神经系统功能失常综合征,全球约5千万人受该病的影响,目前以药物治疗为主,通过药物治疗约50%的患者能够治愈,另外25%的患者症状能够缓解[1]。患者诊断为癫痫拟给予药物治疗时,制定方案应综合其发病年龄、发作     

抗癫痫药物对认知功的影响

认知功能是指接受、加工、储存和应用信息的能力.它是人们成功地完成各种活动最重要的心理条件.理解力、记忆力、注意力、学习能力、警觉和想象能力等均被认为是重要的认知能力[1].癫痫患儿的认知能力受癫痫发作、社会心理因素、抗癫痫药物(AEDs)等多种因素的影响.儿童较成人而言,由于大脑兴奋性和抑制性尚未达到平衡,更易罹患癫痫,且更易发生认知功能障碍.AEDs在减低致痫神经元兴奋性的同时亦降低了正常神经元的兴奋性,从而损伤认知功能.     

抗癫痫药物对认知功能的影响

认知功能是指接受、加工、储存和应用信息的能力。它是人们成功地完成各种活动最重要的心理条件。理解力、记忆力、注意力、学习能力、警觉和想象能力等均被认为是重要的认知能力[1]。癫痫患儿的认知能力受癫痫发作、社会心理因素、抗癫痫药物(AEDs)等多种因素的影响。儿童较成人而言,由于大脑兴奋性和抑制性尚未达到平衡,更易罹患癫痫,且更易发生认知功能障碍。AEDs在减低致痫神经元兴奋性的同时亦降低了正常神经元的兴奋性,从而损伤认知功能。目前,使用AEDs仍然是癫痫治疗的主要方法,而认知功能损害是影响癫痫患儿生活质量的重要因素…     

抗癫痫药物对认知功能的影响

认知功能是指接受、加工、储存和应用信息的能力。它是人们成功地完成各种活动最重要的心理条件。理解力、记忆力、注意力、学习能力、警觉和想象能力等均被认为是重要的认知能力。癫痫患儿的认知能力受癫痫发作、社会心理因素、抗癫痫药物（AEDs）等多种因素的影响。儿童较成人而言，由于大脑兴奋性和抑制性尚未达到平衡，更易罹患癫痫，且更易发生认知功能障碍。     

抗癫痫药物对体质量指数的影响

目的 研究抗癫痫药物对患者体质量指数（BMI）的影响. 方法 收集癫痫患者中BMI＞15 kg.（m²）^-1的患者共74例,比较BMI与患者年龄、所用药物、食欲以及血药浓度的关系. 结果 常用的抗癫痫药物卡马西平、丙戊酸均可导致患者食欲及体质量增加,而且年龄越小越明显. 结论 癫痫患者使用抗癫痫药物时要注意控制食欲和体质量.     

抗癫痫药物

一、临床常用的抗癫痫药物做为抗癫痫药物,应能提高惊厥阈,但不影响正常敏感性;治疗量所致的安眠作用最小;适合长期应用,其它的副作用也应最小。到目前为止,还没有一种抗癫痫药物能符合上述要求。抗癫痫药物的治疗范围较小,要求到达非癫痫靶组织的药物浓度应尽可能低;相同血药浓度会引起不同的个体效应,所以应确定给药个体化。在癫痫治疗中,联合用药很为普遍,当症状得以控制时应避免一般性药物联合。应注意药物及其活性代谢产物的血浆浓度,常规检查尿及肝功能,以预测     

The Effect of Aromatase Inhibitors on Bone Metabolism

Abstract: Aromatase inhibitors increase the disease‐free survival in patients with receptor‐positive breast cancer. Aromatase is a cytochrome P450 enzyme complex catalysing the conversion of androgens to oestrogens. These properties cause a significant increase in bone loss. In this MiniReview, we present data from the aromatase inhibitor studies and the studies designed to investigate aromatase inhibitor effect on bone metabolism. At the cellular level, oestrogen has profound effects on both osteoblasts and osteoclasts. Oestrogen decreases the osteoblastic production of resorptive cytokines and simultaneously increases the production of antireceptive cytokines, which leads to increased osteoclastic apoptosis and increased osteoblastic activity. Aromatase inhibitors inhibit the endogenous production of oestrogen by 50–90%. Studies designed to look at the effect of aromatase inhibitors on bone mineral density have shown a significant decrease in bone mineral density of the femoral neck in the aromatase inhibitor groups compared to placebo groups. Placebo‐controlled studies lack statistical power to detect changes in fracture incidence; however, aromatase inhibitors increase the incidence of fractures in comparison with tamoxifen. We conclude that treatment with aromatase inhibitors leads to an increased bone loss and thus an increase in the risk of fractures in women with breast cancer.     

儿童抗癫痫药物治疗药物监测

抗癫痫药物（AEDs）是治疗癫痫的主要药物,现有27种抗癫痫药物,这使得治疗药物监测（TDM）的应用越来越广泛,同时,抗癫痫药物也是进行TDM最常见的药物。第一代抗癫痫药物卡马西平、苯巴比妥、苯妥英钠、乙琥胺、扑米酮、丙戊酸在TDM方面积累了很多经验,现在TDM将更多地应用于新的抗癫痫药物如醋酸艾司利卡西平、非氨酯、加巴喷丁、拉科酰胺、拉莫三嗪、左乙拉西坦、奥卡西平、吡仑帕奈、哌拉西坦、普瑞巴林、瑞替加滨、卢非酰胺、司替戊醇、噻加宾、托吡酯、氨己烯酸和唑尼沙胺。本文通过对样本类型、样本的采集和处理、参考范围的概念进行综述,旨在为儿童抗癫痫用药的药物监测提供依据。     

蛇床子素对青年大鼠骨代谢的影响研究

目的 探讨蛇床子素对青年大鼠骨代谢的影响.方法 30只雌性wistar大鼠按体重随机分为A、B、C组,A组为正常对照组给予等体积蒸馏水灌胃,B组给予雌二醇灌胃,C组给予蛇床子素灌胃.3组分别在灌胃后4、8、12周分别测定全身骨密度,并在12周后检测左侧股骨和腰椎骨密度及右侧股骨和第4腰椎生物力学性能;检测血清抗酒石酸酸性磷酸酶-5b(TRAP-5b)和骨钙素(0C)含量,分析右侧胫骨骨形态计量学.结果 B、C组灌胃12周后全身骨密度及离体骨密度均高于A组,但C组低于B组(P＜0.01).B、C组生物力学性能指标均高于A组,C组股骨弹性模量和腰椎最大载荷低于B组(P＜0.05).B、C组TRAP-5b水平均低于A组,OC水平高于A组(P＜0.01);C组TRAP-5b水平高于B组,OC水平低于B组(P＜0.01).B、C组胫骨骨组织中骨小梁数量密集,骨小梁分离度低于A组,B组骨小梁数量高于C组,骨小梁分离度低于C组.结论 蛇床子素能够提高青年大鼠骨密度、生物力学性能及骨组织微结构,增加青年大鼠骨质量,但其作用效果略低于雌激素.     

Effect of Zinc on Hepatic Drug Metabolism under Ethanol Toxicity

The effects of zinc on drug-metabolizing enzymes in the liver were examined in male Wistar rats following ethanol intoxication. Rats were orally fed 3 mL of 30% ethanol daily for either two, four, or eight weeks and were orally administered zinc sulfate (ZnSO4.7H2O) at a dose level of 227 mg/L. Levels of reduced glutathione (GSH) and the activities of cytochrome P-450, cytochrome b₅, NADPH cytochrome-C-reductase and glutathione-S-transferase (GST) were determined in liver after two, four, and eight weeks. Significant elevation was observed in the activities of the enzymes of the mixed function oxidase system in response to toxicity induced by ethanol at all the intervals. These effects of were ascribed to the enhanced activity of the microsomal ethanol oxidizing system and the associated increase in reactive oxygen species production. Zinc supplementation to these ethanol-intoxicated animals resulted in normalization of these elevated values significantly, but still they do not attain normal levels. Significant increase was observed in reduced glutathione content in animals after four and eight weeks of ethanol feeding, which appeared to be further elevated in combined zinc and ethanol treatment. Significant elevation in the activity of GST was illustrated on ethanol-fed animals at all the three treatment intervals. Furthermore, the activity of this enzyme was only moderately normalized following zinc treatment. This was accredited to the antioxidant potential of zinc, as well as its ability to induce metallothionein content, which provide protection against the toxic effects of ethanol. To conclude, zinc was able to normalize the effects of ethanol in the liver.     

Antiepileptic Drug Monotherapy: The Initial Approach in Epilepsy Management

Antiepileptic drug (AED) monotherapy is the preferred initial management approach in epilepsy care, since most patients may be successfully managed with the first or second monotherapy utilized. This article reviews the rationale and evidence supporting preferential use of monotherapy when possible and guidelines for initiating and successfully employing AED monotherapy. Suggested approaches to consider when patients fail monotherapy include substituting a new AED monotherapy, initiating chronic maintenance AED polytherapy, or pursuit of non-pharmacologic treatments such as epilepsy surgery or vagus nerve stimulation. Reducing AED polytherapy to monotherapy frequently reduces the burden of adverse effects and may also improve seizure control. AED monotherapy remains the optimal approach for managing most patients with epilepsy.Key Words: New onset epilepsy, antiepileptic drugs, monotherapy, titration.     

Antiepileptic Drug Withdrawal—A Good Idea?

Patients who are seizure free for 2 years or more are candidates for antiepileptic drug (AED) withdrawal. A MEDLINE search of the English language literature from 1980–1996 was performed to identify articles dealing with AED withdrawal in both adults and children. Factors examined included advantages and disadvantages of withdrawal, risks of relapse, prognostic factors of outcome, and methods of withdrawal. Advantages include psychosocial benefits, cost savings (direct drug costs, indirect monitoring costs), and avoidance of adverse effects and toxicity. The benefits must be balanced against the risks and impact of seizure relapse, which are different for each individual patient. A review of the prognostic factors that influence the risk of relapse will aid clinicians in determining appropriate candidates for AED withdrawal.     

新型抗癫痫药物奥卡西平基因多态性研究进展

奥卡西平是癫痫部分性发作和全面强直阵挛性发作的首选药物之一,是卡马西平的一种10-酮类衍生物,其耐受性好且不良反应少。然而,临床研究表明奥卡西平在相同群体的不同个体和不同群体之间呈现出显著差异,其中遗传因素起到重要作用。本文通过收集近年来国内外有关奥卡西平代谢酶、转运体、药效靶蛋白以及不良反应方面有关基因多态性的文献报道,进一步明确其对奥卡西平血药浓度、疗效及不良反应的影响,为临床个体化治疗提供参考。     

鲑鱼降钙素对老年性骨质疏松症骨密度和骨生化指标的影响

目的 :探讨鲑鱼降钙素治疗老年性骨质疏松症的疗效。方法 :120例老年性骨质疏松症患者随机分为试验组和对照组。对照组服用钙尔奇 -D和维生素AD ,治疗组在对照组治疗基础上加用鲑鱼降钙素。结果 :治疗6个月后 ,试验组腰椎L3～4、股骨颈部的骨密度较治疗前明显升高 (P<0 05) ,Wards区骨密度无显著性改变 ,而对照组各部位骨密度较用药前无明显改变 (P>0 05) ;试验组骨痛总有效率为92 31 % ,对照组为30 91 % (P<0 01) ;试验组血碱性磷酸酶、骨钙素较治疗前明显下降 (P<0 05) ,对照组用药前、后无明显改变。结论 :鲑鱼降钙素与钙剂联合治疗老年性骨质疏松症 ,能有效缓解骨痛 ,提高患者骨量的作用。     

抗癫痫药高敏综合征3例临床分析

目的探讨儿童抗癫痫药高敏综合征（antiepileptic drug hypersensitivity syndrome,AHS）的临床特点。方法通过对3例AHS临床资料回顾及复习国内外文献,总结AHS的临床特点。结果AHS患儿均有发热、皮疹及内脏损害,有的患儿的皮疹表现为中毒性表皮松解症。结论确诊AHS后立即停用致敏抗癫痫药及应用糖皮质激素和丙种球蛋白是治疗的关键。