癫痫患者骨密度改变的性别差异及相关影响因素分析

目的评价癫痫患者骨密度及骨代谢相关指标的改变,探讨癫痫患者骨代谢异常的性别差异及其相关影响因素,旨在为临床治疗提供依据。方法入选110例女性癫痫患者及96例男性癫痫患者进行观察,并设立健康女性45例及健康男性40例作对照。收集癫痫患者相关临床资料,对各组分别测定骨密度及骨代谢相关生化指标,并进行统计学分析。结果癫痫组骨密度异常比例及甲状旁腺素均较健康对照组升高,女性癫痫组骨密度异常比例高于男性癫痫组（均P〈0.05）。影响因素分析中,年龄、药程、药物数量、癫痫发作对骨密度均有负面作用（均P〈0.05）,年龄对女性患者骨密度影响更加明显,病程、药物种类仅对女性患者骨密度影响显著。多因素回归分析显示,年龄、病程、药物数量是女性患者骨质异常的危险因素,而药程、药物数量是男性患者骨质异常的危险因素（均P〈0.05）。结论癫痫病及抗癫痫药（AEDs）均影响患者骨密度,并可继发甲状旁腺功能亢进。女性患者骨密度异常比例高于男性患者,且骨质异常的影响因素更多,在临床治疗中应给予更多的关注。

Gender differences of bone mineral density and relative factors in patients with epilepsy

Objective To evaluate the bone mineral density（ BMD） and relative biochemical indicators of bone metabolism in patients with epilepsy,to explore influencing factors and gender differences of abnormal bone metabolism in patients with epilepsy,to provide reference data for clinical treatment. Methods A total of 110 female with epilepsy and 96 male with epilepsy were observed, compared to 45 healthy women and 40 healthy men as control groups.Clinical data of patients with epilepsy were collected, BMD and biochemical indicators were measured in the experimental groups and the control groups respectively. The all of the data were analyzed by statistical methods. Results Incidence of low BMD and the parathyroid hormone increased in the patients groups compared to the healthy groups,incidence of low BMD in female patients group was higher than male patients group（P0.05）. Analysis of influencing factors,age 、time on treatment 、number of antiepileptic drugs（AEDs） and seizures all have adverse impact on BMD（P0.05）. The effect of age on BMD was more visible in female patients group. Significant effect of course and type of AEDs on BMD was only found in female patients group. Mutivariate regression analysis showed,age、course、number of AEDs were risk factors to female patients with abnormal bone metabolism,while time on treatment、number of AEDs were risk factors to male patients（P0.05）. Conclusion Epilepsy and AEDs both have negative impact on BMD, and may lead to secondary hyperparathyroidism. Incidence of low BMD in female patients group was higher than male patients group, and more influencing factors contribute to abnormal BMD in female patients than male patients, so more attention should be paid to female patients in clinical treatment.