拉莫三嗪与奥卡西平单药治疗成人新诊断局灶性癫痫的长期疗效及安全性比较

目的 比较拉莫三嗪(LTG)和奥卡西平(OXC)单药治疗成人新诊断局灶性癫痫的长期疗效、耐受性和安全性。方法 收集本院癫痫专病门诊新诊断的局灶性癫痫,随机分成OXC组和LTG组,根据临床情况调整剂量,OXC最大剂量1200 mg/d,LTG最大剂量300 mg/d,至少随访3年,评估二种药物单药治疗成人新诊断局灶性癫痫无发作率、保留率及不良反应。结果 2009年6月-2016年6月符合入组标准146例,其中OXC组74例,LTG组72例,2组1年无发作率分别为35.1%和51.3%(χ2=3.9,P=0.047),3年无发作率分别为21.6%和40.2%(χ2=5.96,P=0.015),LTG组总体无发作率高于OXC组(P<0.05); OXC组和LTG组1年保留率分别为59.5%和69.4%(χ2=1.59,P=0.208),3年保留率分别为44.6%和51.4%(χ2=0.68,P=0.411),LTG组总体保留率亦高于OXC组,但无明显差异(P>0.05)。OXC组和LTG组最常见的不良反应均为皮疹(6.8% vs. 8.3%)。结论 LTG单药治疗新诊断成人局灶性癫痫的长期无发作率高于OXC,两者不良反应较轻,有较好的安全性。

The comparison of long-term efficacy and safety of oxcarbazepine and lamotrigine monotherapy for newly diagnosed focal epilepsy in adults

ObjectiveTo compare the long-term efficacy, tolerability, and safety of oxcarbazepine(OXC)and lamotrigine(LTG)monotherapy for newly diagnosed focal epilepsy patients in adults.Methods One hundred and forty-six newly diagnosed focal epilepsy patients aged 16 to 75 years were enrolled in this study between June 2009 and June 2016. Among the patients, 74 were randomized treated with OXC and 72 were randomized treated with LTG monotherapy.Results The one-year seizure-free rate of OXC group(35.1%)was significantly worse than that with LTG group(51.3%)(P<0.05),and three-year seizure-free rate with LTG group(40.2%)was significantly better than that with OXC group(21.6%)(P<0.05). However, no significant difference was observed between the two drugs for the one-year retention rate and three-year retention rate(all P>0.05).Conclusion The results of the study showed that LTG was significantly superior to OXC for the treatment of newly diagnosed focal epilepsy.