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1、癲癇患者骨密度改變的性別差異及相關(guān)影響因素分析[摘要]目的評(píng)價(jià)癲癇患者骨密度及骨代謝相關(guān)指標(biāo)的改變,探討癲癇患者骨代謝界常的性別差界及其相關(guān)影響因素,旨在為臨床治療提供依據(jù)。方法入選110例女性癲癇患者及96例男性癲癇患者進(jìn)行觀察,并設(shè)立健康女性45例及健康男性40例作對(duì)照。收集癲癇患者相關(guān)臨床資料,対各組分別測(cè)定骨密度及骨代謝相關(guān)生化指標(biāo),并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果癲癇組骨密度異常比例及甲狀旁腺素均較健康對(duì)照組升高,女性癲癇組骨密度顯常比例高于男性癲癇組(均P<0.05)o影響因素分析中,年齡、藥程、
2、藥物數(shù)量、癲癇發(fā)作對(duì)骨密度均有負(fù)面作用(均P<0.05),年齡對(duì)女性患者骨密度影響更加明顯,病程、藥物種類僅對(duì)女性患者骨密度影響顯著。多因素回歸分析顯示,年齡、病程、藥物數(shù)量是女性患者骨質(zhì)異常的危險(xiǎn)因素,而藥程、藥物數(shù)量是男性患者骨質(zhì)異常的危險(xiǎn)因素(均P<0.05)o結(jié)論癲癇病及抗癲癇藥(AEDs)均影響患者骨密度,并可繼發(fā)甲狀旁腺功能亢進(jìn)。女性患者骨密度異常比例高于男性患者,且骨質(zhì)異常的影響因素更多,在臨床治療中應(yīng)給予更多的關(guān)注。[關(guān)鍵詞]癲癇;骨密度;抗癲癇藥物;性別差異[中圖分類號(hào)]R742.
3、1[文獻(xiàn)標(biāo)識(shí)碼]B[文章編號(hào)]1673-9701(2014)33-0009-04[Abstract]ObjectiveToevaluatethebonemineraldensity(BMD)andrelativebiochemicalindicatorsofbonemetabolisminpatientswithepilepsy,toexploreinfluencingfactorsandgenderdifferencesofabnormalbonemetabolisminpatientswithe
4、pilepsy,toprovidereferencedataforclinicaltreatment.MethodsAtotalof110femalewithepi1epsyand96malewithepilepsywereobserved,comparedto45healthywomenand40healthymenascontrolgroups.Clinicaldataofpatientswithepilepsywerecollected,BMDandbiochemicalindicatorsw
5、eremeasuredintheexperimentalgroupsandthecontrolgroupsrespectively.Theallofthedatawereanalyzcdbystatisticalmethods.ResultsIncideneeoflowBMDandtheparathyroidhormoneincreasedinthepatientsgroupscomparedtothehealthygroups,incidenceoflowBMDinfemalepatientsgr
6、oupwashigherthanmalepatientsgroup(P<0-05).Analysisofinfluencingfactors,age>timeontreatment>numberofantiepilepticdrugs(AEDs)andseizuresal1haveadverseimpactonBMD(P<0.05).TheeffectofageonBMDwasmorevisibleinfemalepatientsgroup?Significanteffectofcourseandt
7、ypeofAEDsonBMDwasonlyfoundinfemalepatientsgroup.Mutivariateregressionanalysisshowed,age>course、numberofAEDswereriskfactorstofemalepatientswithabnormalbonemetabolism,whi1etimeontreatment、numberofAEDswereriskfactorstomalepatients(P<0.05)?ConclusionEpilep
8、syandAEDsbothhavenegativeimpactonBMD,andmayleadtosecondaryhj^perparathyroidism.IncideneeoflowBMDinfemalepatientsgroupwashigherthanmalepatientsgroup,andmoreinfluencingfactorscontributetoabnormalBMDinfemalepatientsthanmalepatients,somorea