| ObjectiveEpilepsy, one of neural common diseases, caused by the nerve cells’repeated attack paradoxical discharge. Incidence of epilepsy is second only tostroke. Majority of the epilepsy originated from childhood. Children period isthe key to the growth and development period. The damage of the body andintelligence caused by the recurrently epilepsy greatly affected the growth anddevelopment of children with epilepsy. It was caused by the oxygen to braincells. At present, the main method for the treatment of epilepsy is still takingantiepileptic drugs. In the late1960s, scholars abroad discovered that theincidence of the fracture of those who took traditional antiepileptic drugssignificantly higher than the normal children didn’t take medicine. Theincidence of other metabolic bone diseases, for example Osteoporosis andOsteomalacia, are also gradually improved. In recent years, with the advent ofnew antiepileptic drugs, people for the treatment of epilepsy tend tomonotherapy. With the improvement of epilepsy drugs, people not only focuson how to control the seizures, but also pay attention to the side effects ofantiepileptic drugs. Utmost to prevent and reduce the negative impact ofchildren with epilepsy medication after, is people’s hot spot for children withepilepsy to obtain good quality of life and the best developmental state.In the process of oral antiepileptic drugs for a long time, studies havefound that the traditional antiepileptic drugs, for example phenobarbital,carbamazepine, Valproic acid, can reduce bone mineral density andmetabolism. Valproic acid also has a same negative effect. New antiepilepticdrugs can also impact on bone metabolism of certain. At present, the studiesabout topiramate and levetiracetam’s monotherapy effects on bone metabolismare very few. This experiment through research the changes of bone metabolism causedby antiepileptic drugs topiramate and levetiracetam to the school periodepilepsy children before and after medicine, to discuss the effect of topiramateand levetiracetam to bone metabolism of epileptic children and may affect theshortest time, to evaluate the safety of the children’s drugs and reduce the sideeffect of the epileptic drugs.MethodsCollect in October2012-2013was starting October6-1460cases inchildren with epilepsy who come from the professional outpatient pediatricmedicine of the second hospital HeBei University as study object. There are32cases male in them, the others are female. Randomly selected30cases usedfor single-agent TPM treatment (male16cases, female14cases). The other30cases used for single-agent LEV treatment. In our contemporary age andgender and group matching,30cases healthy children don’t taking as controlgroup. In2001, the international union of antiepileptic diagnosed in theclassification of the diagnostic criteria of primary epilepsy. The researchobjects of elected to meet certain into the exclusion criteria. That conforms tothe age of6-14years old, normal well life habit, diet, daily life activities.Attacks more than2times per month, disease course of epilepsy for more than2weeks.24h period between electroencephalogram (EEG) in attack period orattack the sharp wave, spike wave, sharp spike wave, spines slow wavewaveform, etc. At the same time except with neurological mental illnesspatients, living area and living standards are highly difference, affect bonemetabolic diseases such as Parathyroid dysfunction, thyroid diseases,achondroplasia, rachitis, severe liver and kidney disease, take adrenal corticalhormones, sex hormones, and therapeutic doses of vitamin D and calcium, andother drugs affect bone metabolism.Meet the conditions for the experiment of60cases of children withepilepsy, according to the condition of oral topiramate and levetiracetamtreatment. Topiramate starting dose of1mg/kg, D, two times, gradually addedamount, after1week every time plus1mg/kg, two oral, general treatment dose for3-5mg/kg, average of4mg/kg, two oral. Levetiracetam’s treatmentstarting quantity10mg/kg, oral points2times a day, add10mg/kg every7days. The general therapeutic dose is20to40mg/kg. Oral points2times aday. Before treatment and after treatment for3months,6months,9monthstesting the experimental parameters of Ca, P, iPTH index changes. UsingSPSS13.0software package to analyze test data processing, determine thetopiramate and Levetiracetam to children with newly diagnosed epilepsy isinfluential bone metabolism.Results1Children with epilepsy group before treatment (TPM and LEV group)compared with control group, blood calcium and blood phosphorus and iPTHand bone metabolism index had no significant difference, P>0.05.2TPM monotherapy group before and after treatment for3months,6Months,9months significantly lower blood Ca (2.48±0.17,2.36±0.14,2.36±0.13,2.35±0.13), there are significant difference, P<0.05. Blood P, iPTH,There was no significant difference compared with before treatment, P>0.05,there are differences between treatment groups, but there was no significantdifference, P>0.05.3LEV group after treatment for3months,6months,9months of bloodCa, P, index than before with monotherapy had no significant difference(P>0.05). LEV oral after3months,6months,9months, iPTH compared withbefore treatment increased(59.00±10.31,63.55±5.93,62.05±7.54vs40.80±15.40), there is no significant difference,P>0.05. After treatment for3months,6months,9months each group there are differences between eachother, but there are no significant difference,(P>0.05).ConclusionsTopiramate can cause decrease of blood calcium in the blood phosphorus,iPTH effect is not obvious, can indirectly affect bone metabolism in childrenwith epilepsy. It was suggested that during the long-term use of TPM, regularmonitoring of blood calcium changes, taking calcium and vitamin D as earlyas possible. The effect of Levetiracetam for blood calcium, phosphorus, iPTH effectis not obvious, little influence on the bone metabolism in children withepilepsy. Medication for a long time still suggests monitoring bonemetabolism index, oral calcium and vitamin D in a timely manner. |
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