拉莫三嗪对癫癎患者生活质量影响的研究

目的:评价拉莫三嗪对癫癎患者生活质量的影响.方法: 采用多中心、前瞻性的研究方法,对新诊断癫癎患者应用拉莫三嗪治疗,并在基线期及用药6个月后,采用QOLIE-31、MOS SF-36量表、数字符号转换测验、HAMD抑郁量表和女性专用调查问卷对患者进行生活质量评价.结果: 共纳入新诊断癫癎患者282例.MOS SF-36量表的8个项目得分在用药后均有显著提高(P<0.01);QOLIE-31问卷中"对癫癎的担心","情绪"、"活力","认知","药物不良反应"、"社会功能"及"总体自身健康评价"项目得分在用药后均有显著提高(P<0.01).用药后,患者Hamilton抑郁量表平均3.65分,显著低干基线期6.42分(P<0.01);数字符号转换测验得分在用药后与基线期比较有显著提高(P<0.01).结论: 拉莫三嗪初始单药治疗能在一定程度上改善新诊断癫癎患者的生活质量.     

拉莫三嗪单药治疗新诊断的成人癫(癎)的临床疗效

目的:观察拉莫三嗪对新诊断成人癫(癎)的疗效.方法:对56例新诊断癫(癎)患者给予拉莫三嗪单药治疗.结果:56例患者中完全控制13例,显效22例,有效9例,无效8例,失访4例,完全控制率为23%,总有效率为79%.结论:拉莫三嗪是治疗新诊断成人癫(癎)的一种安全、有效药物.     

拉莫三嗪添加治疗癫癎的长期研究

目的　观察拉莫三嗪 (LTG)添加治疗癫长期开放性观察的临床疗效和安全性。方法　据添加LTG前 3个月基线月均发作频率 ,将 94例癫患者分为非难治性癫组 5 8例 (NIE组 )和难治性癫组 3 6例 (IE组 ) ,将每例最后 6个月的月均发作频率与基线进行比较 ,并观察其副反应。结果　总有效率为 69 1%。NIE组有效率 (84 5 % )、控制率 (63 8% )较IE组 (4 4 4% ,2 2 2 % )明显为高。IE组的疗效与我们均期 1年的观察结果近似。LTG与丙戊酸 (VPA)配伍应用 ,疗效较好 ,且可以减少LTG的剂量。副反应主要为皮疹 (12 8% )。结论　LTG添加治疗癫疗效稳定 ,耐药性、副反应少 ,是适于长期应用的新的高效抗癫药物之一。     

拉莫三嗪治疗卒中后癫(癎)的疗效观察

目的 探讨拉莫三嗪治疗卒中后癫(痫)的临床效果和预后.方法 60例卒中后癫(痢)患者随机分为观察组30例和对照组30例,对照组采用丙戊酸钠治疗,观察组口服拉莫三嗪,比较2组癫(痫)复发情况.结果 观察组癫(痫)发作率13.3％,对照组发作率36.7％,2组比较差异有统计学意义(P＜0.05).结论 拉莫三嗪治疗卒中后癫(痫)效果较满意,且无明显不良反应,值得临床推广.     

拉莫三嗪对新诊断成人癫癎患者生活质量的影响

随着健康定义的改变,医学模式也从单纯的生物医学模式转变为生物一心理一社会医学模式。因此,癫癎治疗及康复的目的不再局限于发作的控制和症状的缓解,而是使患者的健康状况全面改善或恢复。本研究采用两个量表调查拉英三囔（LTG）对新诊断成人癫癎患者生活质量的影响。探讨和发现影响生活质量的因素,对于采取多方面的综合治疗措施,为提高成人癫癎患者生活质量提供理论依据。     

拉莫三嗪对特殊类型癫癎的疗效观察

目的观察拉莫三嗪(LTG)对特殊类型人群(育龄期女性)部分发作性癫癎患者的疗效和安全性。方法临床确诊的育龄期女性部分性发作癫癎患者90例,LTG单药治疗,定期随访,进行疗效和不良反应的观察。结果 LTG单药治疗育龄期女性部分性发作癫癎患者的有效率在76.7%以上,患者在用药后无一例重度不良反应。结论 LTG对育龄期女性部分性发作癫癎患者的疗效确切,安全性好,对怀孕和生育过程影响较小。     

拉莫三嗪作为首次用药对癫癎患儿的临床疗效及不良反应的评价

癫癎是一种常见的神经系统慢性反复发作性疾病。拉莫三嗪作为一种新型抗癫癎药物,于1994年开始在我国用于抗癫癎治疗,对多种类型的癫癎发作均有效[1],通过作用于钠通道、抑制兴奋性神经递质的病理性释放而发挥抗癫癎作用[2-3],其不良反应相对于其他抗癫癎药物较小,且对认知功能的影响较小或有保护作用。     

拉莫三嗪治疗癫癎的有效性与剂量、血药浓度及合并用药关系的研究

目的探讨拉莫三嗪(LTG)单药及不同配方治疗癫癎的有效性及与血药浓度等相关因素的关系。方法 126例患者分4组:拉莫三嗪单药治疗组(LTG)42例;服丙戊酸(VPA)以拉莫三嗪为添加治疗的LTG+VPA 组35例;服丙戊酸和卡马西平(CBZ)添加拉莫三嗪组(LTG+VPA+CBZ)33例;服卡马西平添加拉莫三嗪(LTG+ CBZ)组16例。拉莫三嗪按常规逐渐加量,在达到目标剂量后一个月及有效维持量时采血,高效液相色谱法测拉莫三嗪、丙戊酸及卡马西平血药浓度。结果拉莫三嗪单药或合并用药时疗效无明显差异,总有效率为81．8％,对全面性发作效果较佳,有效率90．6％,尤其是失神发作;对部分性发作有效率75．0％,两者有显著性差异。89％的有效患者拉莫三嗪血药浓度在1-8μg/mL范围内,且此范围内疗效与血药浓度呈正相关。血药浓度>8μg/mL时不良反应发生率增加有显著性。本组患者中无皮疹发生,可能与研究中起始剂量低、加量慢有关。结论拉莫三嗪单药及不同配方情况下对癫癎全面性发作效果更好。其有效血药浓度范围较大,且与疗效和副作用相关。     

男性癫癎患者服用抗癎药物后血清甲状腺激素水平及临床意义

目的研究接受卡马西平(CBZ)、鲁米那(PB)和丙戊酸钠(VPA)单药治疗的成年男性癫(疒间)患者的甲状腺激素水平及意义.方法应用放免法测定63例男性癫(疒间)患者(22例服用CBZ,18例服用PB,23例服用VPA)及20名健康对照者血清中的总甲状腺素(TT4)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)水平.结果 CBZ组TT4、FT4和FT3较对照组明显降低(均P＜0.05),TT3和TSH水平无变化;PB组的TT4和FT4较对照组明显降低(均P＜0.05),TT3、FT3和TSH水平无变化;且PB组的TT4、FT4降低程度均较CBZ组轻;VPA组各项指标均无变化.结论 CBZ、PB可通过肝酶诱导等多种途径导致甲状腺激素水平发生改变,二者的作用不完全相同;VPA对甲状腺功能无影响,有必要对服用抗(疒间)药物,尤其是CBZ患者的甲状腺激素水平进行监测.     

脑梗死后癫(癎)患者血清细胞因子水平的改变

目的 研究脑梗死后癫(癎)患者血清细胞因子水平的改变.方法 应用放射免疫法检测87例脑梗死后癫癎患者(脑梗死癫(癎)组)和75名健康体检者(正常对照组)的血清肿瘤坏死因子α(TNF-α),白细胞介素(IL)-2和IL-6水平.结果 脑梗死癫(癎)组血清TNF-α[(2.5±0.57)ng/L]、IL-2[(9.0 4-0.83)ns/L]及IL-6[(97.5±3.1)ng/L]水平明显高于正常对照组[TNF-α(0.89 4-0.36)ng/L,IL-2(4.3±1.5)ng/L,IL-6(13.3 4-11.1)ng/L](均P＜0.01).结论 脑梗死后癫(癎)患者的血清细胞因子TNF-α、IL-2及IL-6水平显著升高,提示细胞因子可能在脑梗死后癫(癎)的发病中起重要作用.     

托吡酯长期治疗对成年癫疒间患者血清甲状腺激素水平的影响

目的 探讨托吡酯(TPM)长期治疗对成年癫疒间患者血清甲状腺激素水平的影响.方法 用化学发光分析法测定成年癫疒间组患者(32例)TPM治疗前、后的血清甲状腺激素水平,并与健康对照组(40人)进行比较. 结果治疗前成年癫疒间组患者甲状腺激素水平与健康对照组比较无统计学意义(均P>0.05);TPM治疗后3个月、6个月、12个月及24个月的甲状腺激素水平与治疗前及健康对照组比较差异亦无统计学意义(均P>0.05).结论 TPM短期与长期治疗对成年癫疒间患者的甲状腺激素水平没有影响.     

Lamotrigine therapy of epilepsy with Angelman's syndrome

PURPOSE: Angelman syndrome (AS) is a neurogenetic disorder characterized by developmental delay and a frequently refractory epileptic condition. Valproate, clonazepam and/or phenytoin are said to be the most effective antiepileptic drugs (AEDs) against the seizures in AS. Experience with the newer AEDs is very limited despite their better safety profile and tolerability. Considering its favorable side effect profile and its effectiveness against both partial and generalized seizures, we hypothesized that lamotrigine (LTG) might be more efficacious and better tolerated. METHODS: Potential patients for this retrospective study were identified from the epilepsy clinics at Notre-Dame, Sainte-Justine, and Yale New Haven hospitals. Patients were included in the study if they had AS along with refractory seizures. The medical record of each patient was reviewed with interest on seizure types, previous AEDs and response to LTG. RESULTS: Five patients (2M, 3F) were included in this study. Age at LTG ranged from 10 to 33 years old. All had >or=2 seizure types, mainly generalized tonic-clonic, myoclonic seizures, and atypical absences. Previously tried AEDs included valproic acid (5), benzodiazepines (5), phenytoin (4), carbamazepine (3), and topiramate (1). One patient had pancreatitis on phenytoin, one had worsened seizures on carbamazepine, and one developed hepatic encephalopathy on valproic acid. Three patients became seizure-free with LTG (9, 20, and 36 months FU), one was seizure-free for 1 year with subsequent loss of efficacy, and one showed >50% reduction in myoclonic seizures (20 months FU). No side effects were reported. CONCLUSION: LTG can be efficacious and well tolerated in patients with AS.     

女性抑郁症患者血清甲状腺激素水平研究

目的:探讨女性血清甲状腺激素水平与抑郁症的关系.方法:采用免疫化学发光法对58例女性抑郁症患者及对照组40例健康女性的血清游离三碘甲状腺原氨酸(FT3),游离甲状腺素(FT4),促甲状腺素(75H)进行了检测.结果:女性抑郁症患者治疗前血清FP4,TSH较对照组低(P均<0.01),而FT3与对照组差异无显著性(P>0...     

托吡酯与卡马西平对成年癫痫患者甲状腺激素的影响

目的探讨托吡酯（TPM）及卡马西平（CBZ）对成年癫痫患者甲状腺激素水平的影响。方法选择新确诊的100例成年癫痫患者（50例服用TPM、50例服用CBZ）为试验组,用化学发光法测定用药前甲状腺激素水平并与40例成年健康对照进行比较；再经TPM、CBZ单药治疗3、6个月及1年后检测血中甲状腺激素水平,并与治疗前比较。结果未经治疗的癫痫患者甲状腺激素水平与正常对照组比较无显著性差异（P＞0．05）；与治疗前相比,CBZ治疗3个月、6个月及1年后的游离T4（FT4）、三碘甲状腺原氨酸（TT3）及CBZ治疗6个月及1年后的甲状腺素（TT4）显著降低（P＜0．05）,而CBZ治疗3个月的TT4与服用CBZ后各时点的游离T3（FT3）、促甲状腺素（TSH）无显著性变化（P＞0．05）；经TPM治疗后的不同时段的甲状腺激素水平与治疗前比较均无显著性差异（P＞0．05）。结论CBZ治疗可造成成年癫痫患者甲状腺激素水平的降低。癫痫本身及TPM治疗并不引起成年患者甲状腺激素水平的改变,表明TPM治疗对成年癫痫患者的甲状腺功能更安全。     

女性癫痫患者血清性激素水平的调查研究

目的了解癫痫发作频率、抗癫痫单药/联合用药治疗及围经期癫痫对女性癫痫患者性激素水平的影响。方法测定入组的87例女性癫痫患者血清泌乳素、雌激素、孕激素、睾酮水平,根据发作频率、单药/联合用药治疗及是否围经期癫痫分组,并比较不同组间性激素的变化。结果高发作频率组泌乳素升高率及发病年龄明显高于低发作频率组和无癫痫发作组;其孕激素下降率高于低发作频率组(P均0.05)。联合用药治疗组睾酮升高率明显高于单药治疗组(P0.05)。围经期癫痫组泌乳素升高率、孕激素下降率及雌/孕比值明显高于非围经期癫痫组(P均0.05)。结论泌乳素升高与近期癫痫发作有关;孕激素下降与癫痫发作严重性有关;抗癫痫药物影响性激素水平,尤以联合应用丙戊酸钠对睾酮作用显著。孕激素、雌/孕比与围经期癫痫密切相关,孕激素补充疗法可能是治疗围经期癫痫的一条有效途径。     

比较奥卡西平或拉莫三嗪联合丙戊酸钠治疗脑外伤术后癫疒间复发疗效

目的探讨丙戊酸钠治疗脑外伤术后癫疒间复发后,添加奥卡西平或拉莫三嗪联合治疗外伤性癫疒间效果。方法以治疗前3个月癫疒间发作频度为对照,对治疗12个月后的疗效、不良反应及安全性进行自身对比观察。结果应用奥卡西平或拉莫三嗪联合丙戊酸钠治疗12个月后,患者发作频率均较用药前明显减少;发作频率减少≥50%的患者分别为89.2%和89.7%,用药前后差异无统计学意义(P<0.05);奥卡西平或拉莫三嗪联合丙戊酸钠两组间差无明显统计学意义(P>0.05)。奥卡西平联合丙戊酸钠不良反应的发生率为19.3%,拉莫三嗪联合丙戊酸钠不良反应的发生率为9.1%,差异显著(P<0.05)。结论奥卡西平或拉莫三嗪联合丙戊酸钠治疗外伤性癫疒间复发疗效确切,副作用拉莫三嗪组明显低于奥卡西平组。     

Effects of various antidepressants on serum thyroid hormone levels in patients with major depressive disorder

A total of 62 patients with major depressive disorder were analyzed in the study. Patients were evaluated for 11 weeks in an open label design to investigate the differential effects of reboxetine, sertraline and venlafaxine on thyroid hormones. Serum thyrotrophin (TSH), thyroxine (T4) and free (f)T4 levels were measured before and after treatment. All groups showed significant improvement in HAM-D scores. TSH level significantly reduced and T4 level significantly increased in the reboxetine group, however TSH level significantly increased and T4 level significantly reduced in the sertraline group. Percent changes of TSH (p = 0.007) and T4 (p = 0.001) were significantly different between the reboxetine and sertraline groups. In the sertraline group, baseline TSH levels were correlated with response to treatment as determined by the change in HAM-D scores (p = 0.03, r = 0.648). There was a significant association between the percent changes in TSH values and the reduction in HAM-D scores in the reboxetine group (p = 0.03, r = − 0.434). In the whole study group, female patients had lower values of basal T4 compared with men (p = 0.043), however percent changes of T4 did not differ between genders. In the treatment-responders significant increase in the reboxetine group and significant decrease in the sertraline group regarding the T4 values were found. We observed that various antidepressants had different effects on thyroid hormone levels and this could be attributed to the different mechanisms of actions of these antidepressants.     

Lamotrigine monotherapy compared with carbamazepine, phenytoin, or valproate monotherapy in patients with epilepsy

OBJECTIVE: This open-label study evaluated the efficacy and tolerability of lamotrigine monotherapy compared with monotherapy with conventional antiepileptic drugs in patients converting from previous monotherapy because of inadequate seizure control or unacceptable side effects. METHODS: This study was conducted in 26 neurology clinics and epilepsy centers throughout the United States. The study enrolled 115 patients with epilepsy converting from previous monotherapy because of inadequate seizure control or unacceptable side effects. Patients were randomized 1:1 to receive 24 weeks of lamotrigine monotherapy or monotherapy with a conventional antiepileptic drug (carbamazepine, phenytoin, or valproate based on physician's choice). Patients were converted during an 相似文献   

拉莫三嗪治疗儿童癫痫合并注意障碍伴多动的自身对照研究

目的探讨拉莫三嗪对儿童癫痫合并注意障碍伴多动的治疗效果。方法对拉莫三嗪(LTG)治疗癫痫合并注意障碍伴多动(ADHD)的患儿进行开放性自身对照临床试验,治疗期为1~2年。结果ADHD症状好转者9例,有效率为75%;癫痫发作频度减少≥50%,10例(83%),EEG好转率为75%。结论LTG治疗儿童癫痫合并ADHD是有效的。     

拉莫三嗪对成年癫患者血清中瘦素、抵抗素和脂联素水平的影响

目的探讨抗癫新药拉莫三嗪对成年癫患者血清瘦素、抵抗素、脂联素水平的影响。方法对30名女性健康查体人员和60例首发癫全面性强直-阵挛发作女性患者随机分为拉莫三嗪组和丙戊酸钠组,在治疗前和治疗后分别进行血清瘦素、抵抗素和脂联素水平测定,并测量腰臀比(帆)、体重指数(BMI)。结果拉莫三嗪治疗后、对照组BMI、WHR及血清瘦素、抵抗素、脂联素水平间均无明显差异,而丙戊酸钠治疗后血清瘦素、抵抗素水平明显升高,脂联素水平明显降低(P<0.01)。结论拉莫三嗪治疗不引起癫患者体重增加,瘦素、脂联素、抵抗素水平可能是肥胖发生的预测指标。