左乙拉西坦治疗不同类型小儿癫痫的临床疗效

目的探析左乙拉西坦治疗不同类型小儿癫痫的临床疗效。方法选择我院2012-03—2015-06收治的81例小儿癫痫患者进行研究,随机分为观察组(n=41)与对照组(n=40)。对照组应用丙戊酸钠治疗,观察组在对照组基础上加用左乙拉西坦,比较2组治疗前后癫痫发作频率、治疗总有效率及不良反应发生率。结果 2组治疗前发作频率组间差异无统计学意义(P0.05),治疗后2组发作频率均降低,组内前后差异有统计学意义(P0.05),同时观察组治疗后的发作频率低于对照组,组间比较差异有统计学意义(P0.05),提示观察组发作频率降低幅度更大。观察组不同类型癫痫患者的治疗总有效率为90.2%(37/41),对照组为72.5%(29/40),观察组明显更高,差异有统计学意义(P0.05)。观察组不良反应发生率为31.7%(13/41),对照组为25.0%(10/40),差异无统计学意义(P0.05)。结论左乙拉西坦在不同类型小儿癫痫临床治疗中的应用可大幅降低发作频率,利于强化治疗效果,且安全可靠,可长期用药,值得推广。     

丙戊酸钠联合左乙拉西坦治疗小儿癫痫的疗效

目的探讨丙戊酸钠联合左乙拉西坦治疗小儿癫痫的临床疗效。方法将92例小儿癫痫患者随机分为对照组和实验组,在丙戊酸钠治疗基础上,对照组联合托吡酯治疗;实验组联合左乙拉西坦治疗。结果实验组总有效率93.5%高于对照组78.3%,治疗前,2组患者血钙和血磷水平无显著差异(P0.05);但治疗后实验组血钙水平(2.39±0.36)mmol/L、血磷水平(1.45±0.36)mmol/L均低于对照组(2.07±0.18)mmol/L、(1.21±0.15)mmol/L(均P0.05)。结论丙戊酸钠、左乙拉西坦联合用药治疗小儿癫痫疗效显著,且对钙、磷代谢影响较小,安全性高,临床值得应用。     

复方氨基丁酸维E胶囊联合左乙拉西坦治疗小儿癫痫的临床疗效观察

目的分析复方氨基丁酸维E胶囊联合左乙拉西坦对小儿癫痫的治疗效果及安全性,为临床治疗小儿癫痫提供参考。方法选择2010-08—2014-08我院收治的小儿癫痫68例为研究对象,随机分为2组。对照组使用左乙拉西坦治疗,实验组在对照组基础上联合使用复方氨基丁酸维E胶囊治疗,对比观察2组疗效。结果实验组总有效率明显高于对照组,发作频率低于对照组,差异有统计学意义(P0.05)。结论复方氨基丁酸维E联合左乙拉西坦治疗小儿癫痫的效果更好,安全性高,值得应用。     

左乙拉西坦与精神行为异常

癫痫作为一种古老的疾病,在全世界有广泛的发病人群,其对于个人、家庭、社会都有严重的负面影响。左乙拉西坦作为第二代抗癫痫药物,因其相对高安全性、药代动力学简单及与其他药物相互作用的发生率低等特点,在临床上广泛应用。虽然左乙拉西坦在控制癫痫发作方面疗效显著,但在使用过程中会出现多种不良反应,如头晕、共济失调,以及包括抑郁、焦虑、情绪不安甚至自杀等精神行为异常。该文主要就左乙拉西坦导致精神行为异常的可能机制、影响因素等方面进行综述,并对临床应用提出建议。     

左乙拉西坦治疗60例小儿癫痫的疗效和安全性分析

目的探讨左乙拉西坦在小儿癫痫治疗中的疗效和安全性。方法从我院2013-06—2014-06小儿神经内科专科门诊部收治的癫痫患儿中随机性抽取60例作为研究对象,采用开放性自对照随访研究方法。60例患儿均给予左乙拉西坦口服治疗,随访6~10个月,观察治疗前后癫痫发作频率变化、脑电图改变情况以及患儿治疗期间的不良反应,评价左乙拉西坦治疗小儿癫痫的疗效和安全性。结果本组患儿均成功获得随访,治疗后完全控制26例,有效20例,无效12例,加重2例,总有效率76.67%,且不同类型癫痫患儿治疗后的发作次数明显低于治疗前(P0.01)。脑电图检查痫样放电消失31例,痫样放电减少50%以上10例,痫样放电减少25%~49%9例,痫样放电无变化7例,痫样放电增加3例。本组治疗期间18例发生不良反应,不良反应发生率30.00%,主要表现为情绪异常、嗜睡乏力、皮疹等症状,给予对症治疗后均得到缓解,无严重影响治疗的不良反应。结论左乙拉西坦治疗儿童癫痫的疗效确切,不良反应少,是一种安全有效的药物。     

左乙拉西坦治疗小儿癫痫疗效的Meta分析

目的评价左乙拉西坦治疗小儿癫痫的疗效和安全性。方法计算机检索近十年(2001-2011)来PubMed、Cochrane Database of Systematic Reviews、EMbase、中国知网(CNKI)检索平台、万方数据库中纳入左乙拉西坦治疗小儿癫痫的随机对照研究(RCTs),研究者对文献质量进行严格评价和资料提取。对符合质量标准的RCTs用Review manager 5.0软件进行Meta分析。结果 6个RCTs共610名患者纳入研究,其中治疗组(使用左乙拉西坦)333例,对照组(常规治疗)277例。Meta分析结果表明治疗组患者每周癫痫发病率明显低于对照组,对于患者继发嗜睡、头痛等中枢系统不良反应及肝肾功能损害方面,RCTs结果显示无显著差异。结论左乙拉西坦治疗不良反应种类少,对各种发作类型的小儿癫痫均有良好疗效,且不增加发生其他不良结局的危险性,可作为小儿癫痫患者的首选治疗方案之一。     

左乙拉西坦治疗成人癫痫的疗效及安全性分析

目的分析左乙拉西坦在成人癫痫患者中的疗效、耐受性及安全性。方法选取我院2013-02—2014-06收治的98例癫痫患者为研究对象,随机分为试验组(LEV治疗)和对照组(常规用药)各49例,疗程40d,观察疗效及不良反应。结果观察组有效率81.6%,对照组为61.2%,2组疗效比较差异有统计学意义(P0.05)。2组指标异常、厌食、嗜睡等不良反应差异无统计学意义(P0.05)。个别患者出现皮疹、白细胞下降症状并不是应用左乙拉西坦造成的。结论左乙拉西坦(LEV)作为一种新型药物,安全性较高,在癫痫治疗的初、中期患者耐受性好,单独使用其治疗效果也十分显著。     

丙戊酸钠联合左乙拉西坦治疗小儿癫痫临床分析

目的 研究丙戊酸钠结合左乙拉西坦治疗小儿癫痫的有效性及安全性.方法 将2015-06—12我院儿科收治的120例小儿癫痫患儿为研究对象,按照数字随机分组法分成3组,给予不同药物进行治疗,分别为丙戊酸钠组(40例)、左乙拉西坦组(40例)与联合治疗组(40例).观察3组疗效、相关实验室指标与安全性.结果 丙戊酸钠组治疗总有效率77.5%,左乙拉西坦组为72.5%,联合治疗组为92.5%,联合治疗组优于其他2组,差异有统计学意义(χ2=2.37、3.92,P均<0.05);3组治疗前后血钙与血磷水平比较,治疗后联合治疗组血钙与血磷水平均优于其他2组,差异有统计学意义(血钙t=1.14、2.51,血磷t=1.35、1.73,P均<0.05).联合治疗组不良反应率5.0%,优于丙戊酸钠组的12.5%与左乙拉西坦组的15.0%,差异有统计学意义(χ2=1.524、1.473,P<0.05).结论 丙戊酸钠联合左乙拉西坦治疗小儿癫痫的疗效更好,安全性更高,值得临床推广.     

左乙拉西坦对小儿癫痫的疗效及TLR4/NF-kB IL-6 TNF-α hs-CRP水平的影响

目的研究小儿癫痫给予左乙拉西坦治疗的效果及对炎症因子血清白介素6(interleukin-6,IL-6)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)及Toll样受体4(TLR4)、核因子(NF-kB)水平的影响作用。方法以商丘市第三人民医院2015-04—2019-04收治的103例小儿癫痫为对象,按照随机数字表法分为2组,对照组51例接受卡马西平治疗,观察组52例患儿接受左乙拉西坦治疗,比较2组治疗总有效率、TLR4/NF-kB水平变化、炎症因子水平变化、认知功能。结果观察组治疗总有效率为94.23%高于对照组的78.43%(P0.05);观察组治疗后TLR4、NF-kB水平均低于对照组(P0.05);观察组治疗后炎症因子IL-6、TNF-α、hs-CRP水平均低于对照组(P0.05)。结论左乙拉西坦治疗小儿癫痫具有良好临床疗效,能够更明显控制TLR4/NF-kB水平,减轻炎症反应,具有良好应用价值。     

左乙拉西坦单药治疗小儿癫痫的自身对照研究

目的研究左乙拉西坦作为单药治疗不同类型癫痫患儿的临床疗效和安全性。方法采用前瞻性研究,对62例不同类型癫痫患儿进行左乙拉西坦单药治疗。左乙拉西坦起始剂量为20 mg/(kg.d),分两次服用,每两周增加10 mg/(kg.d),维持剂量30～40 mg/(kg.d)。稳定期:维持加量期12周,每个月观察1次,以治疗前3个月的发病频率为基础,完成了6个月的观察期,随访6～24个月(平均随访12.8个月),观察发作频率的变化及不良反应。结果 62例入选患儿,完全控制发作38例,占61.3%,显效8例,占12.9%;有效9例,占14.5%;无效4例,占6.5%;加重3例,占4.8%。总有效率为88.7%,两年治疗保留率为72%。左乙拉西坦治疗前后发作频率改变有统计学意义(P0.005)。结论左乙拉西坦作为单药治疗小儿各型癫痫有良好疗效及安全性。     

Intravenous levetiracetam in children with epilepsy

Intravenous levetiracetam recently became available for use in patients aged >16 years. There are few data about its safety and efficacy in children. We retrospectively analyzed data from children treated with intravenous levetiracetam. Ten patients (6 female, 4 male), aged 3 weeks to 19 years, were treated with intravenous levetiracetam at a mean dose of 50.5 mg/kg/day for a mean duration of 4.9 days. Four patients received intravenous levetiracetam for acute repetitive seizures/status epilepticus, and three as replacement for oral levetiracetam because administration of oral levetiracetam was temporarily infeasible. One patient each received intravenous levetiracetam for seizure prophylaxis during brain biopsy, as maintenance treatment after acute seizures, and as substitute for sodium valproate. Three of four patients with acute repetitive seizures/status epilepticus became seizure-free; the fourth patient had a partial reduction in seizure frequency. All three patients who received intravenous levetiracetam as substitute for oral levetiracetam tolerated the switch well. The other three patients were seizure-free on intravenous levetiracetam. No serious adverse effects were observed, and all patients completed treatment with intravenous levetiracetam for the intended period. Intravenous levetiracetam may be effective in various clinical situations requiring intravenous administration of an antiepileptic drug.     

Efficacy and safety of levetiracetam in infants and young children with refractory epilepsy.

The aim of this multicentric, retrospective, and uncontrolled study was to evaluate the efficacy and safety of levetiracetam (LEV) in 81 children younger than 4 years with refractory epilepsy. At an average follow-up period of 9 months, LEV administration was found to be effective in 30% of patients (responders showing more than a 50% decrease in seizure frequency) of whom 10 (12%) became seizure free. This efficacy was observed for focal (46%) as well as for generalized seizures (42%). In addition, in a group of 48 patients, we compared the initial efficacy (evaluated at an average of 3 months of follow-up) and the retention at a mean of 12 months of LEV, with regard to loss of efficacy (defined as the return to the baseline seizure frequency). Twenty-two patients (46%) were initial responders. After a minimum of 12 months of follow-up, 9 of 48 patients (19%) maintained the improvement, 4 (8%) of whom remained seizure free. A loss of efficacy was observed in 13 of the initial responders (59%). Maintained LEV efficacy was noted in patients with focal epilepsy and West syndrome. LEV was well tolerated. Adverse events were seen in 18 (34%) patients. The main side effects were drowsiness and nervousness. Adverse events were either tolerable or resolved in time with dosage reduction or discontinuation of the drug. We conclude that LEV is safe and effective for a wide range of epileptic seizures and epilepsy syndromes and, therefore, represents a valid therapeutic option in infants and young children affected by epilepsy.     

左乙拉西坦联合盐酸舍曲林治疗癫痫伴抑郁患儿的疗效观察

目的 探讨左乙拉西坦联合盐酸舍曲林治疗癫痫伴抑郁症儿童的临床疗效。方法 回顾性分析112例6~15岁癫痫伴抑郁症的临床资料,按年龄分为学龄组（6~12岁,56例）和少年组（13~15岁,56例）,评估治疗前后癫痫发作频率、认知功能（WISC-CR）、汉密尔顿抑郁量表17项（HAMD-17）、生活质量、身体质量指数（BMI）、不良反应发生率。结果 与治疗前相比,两组治疗6、12个月,癫痫发作频率、认知功能、HAMD-17评分、生活质量均显著改善（P<0.05）;同时,学龄组癫痫发作频率、认知功能、HAMD-17评分、生活质量均显著优于少年组（P<0.05）;两组治疗后BMI、不良反应发生率无统计学差异（P>0.05）。结论 采用左乙拉西坦联合盐酸舍曲林治疗癫痫伴抑郁症儿童可获得显著的疗效,其中学龄组疗效优于少年组。     

Efficacy and safety of levetiracetam: an add-on trial in children with refractory epilepsy.

The aim of this multicentric, prospective and uncontrolled study was to evaluate the efficacy and safety of levetiracetam in 110 children with refractory epilepsy, of whom 21 were less than 4 years old. After a median follow-up period of 7 months, levetiracetam administration was effective (responders with >50% decrease in seizure frequency) in 39% of children, of whom 10 (9%) became seizure-free. The efficacy was higher in patients with localization-related epilepsy (58% of responders) than in those with generalized epilepsy (37% of responders). Levetiracetam was well tolerated. The main side effects of somnolence and irritability occurred in 14% of patients. In one patient acute choreoathetosis occurred after few doses of levetiracetam. Overall, the adverse effects were not severe. Children younger than 4 years were particularly tolerant. In conclusion, the present study confirms that levetiracetam is effective and well tolerated as an add-on treatment in children with refractory epilepsy. Our preliminary data also indicate that levetiracetam may be a valid therapeutic option for epilepsy in infants and young children.     

Efficacy and tolerability of levetiracetam in children with epilepsy

Objective: To assess the efficacy and tolerability of levetiracetam (Lev) in children with epilepsy. Methods: Open-label observational, prospective, single arm, non-interventional study examining patients (?14 years) with epilepsy, receiving mono- or combination therapy with levetiracetam. Levetiracetam was started at a dose of approximately 10 mg/kg/day. The dose was titrated up with 10 mg/kg increments if seizures were poorly controlled but the maximum daily dose could not be more than 60 mg/kg/day. Documented were seizure type and frequency, levetiracetam dose and side effects. Results: 120 patients (39.3% females, mean age 4.5 ± 3.9 years) were enrolled. Average duration of follow-up was 10.3 ± 3.5 months. At study endpoint, 64.8% of patients got seizure free and 83.0% got a seizure reduction of ?50%. Observed side effects were somnolence, dysphoria, nervousness, dystrophy, somnipathy, asitia, debilitation, etc. and the incidence rate in the study was 47.5%. Four (3.3%) of 120 patients withdrew because of intolerance of side effects. The estimated one year retention rate of levetiracetam was 73.3%. Poor effect was the most common reason for withdrawal. Conclusions: In our study, it seemed that levetiracetam was safe and effective for a wide range of epileptic seizures in children with epilepsy.     

左乙拉西坦治疗低龄难治性癫痫患儿临床研究

目的 探讨左乙拉西坦治疗低龄难治性癫痫患儿的疗效及安全性.方法 纳入我科2008-01-2013-01收治的≤5岁难治性癫痫患儿,随机均分为实验组与对照组,实验组口服左乙拉西坦,对照组口服卡马西平,评价2组患者治疗13周与26周的疗效以及治疗前后的实验室检查结果、不良反应.结果 用药26周后实验组有效率高于对照组、不良反应发生率低于对照组,差异有统计学意义（P＜0.05）,各项实验室检查结果比较差异无统计学意义（P＞0.05）.结论 左乙拉西坦治疗低龄难治性癫痫患儿的疗效显著,安全性好,值得临床推广.