奥卡西平联合其他抗癫(癎)药治疗儿童癫(癎)的疗效及安全性

目的 探讨奥卡西平(OXC)联合用药治疗儿童癫(癎)的疗效、剂量及药物安全性.方法 收集在本院神经内科门诊就诊的41例癫(癎)患儿.男23例,女18例；就诊年龄6个月～l5岁,平均7.70岁；病程15 d-5 a,平均9个月；随访时间6个月～6a,平均2a6个月.简单局限性发作(SPS)3例,复杂局限性发作(CPS)8例,局限性发作继发全面性发作(sGTCS) 14例,SPS和sGTCS 2种类型均有12例,CPS和sGTCS均有4例.根据应用OXC的先后顺序分为A组与B组:A组为开始应用一种非OXC抗癫(癎)药治疗,因疗效不好,在原用药剂量不变的情况下加用OXC;B组为首选OXC治疗后因仍有发作加用其他抗癫(癎)药物.回顾性分析41例OXC联合用药治疗癫(癎)患儿的临床资料,评估其疗效、药物不良反应及患儿的耐受性.结果 A组29例,经OXC添加治疗完全控制发作者占48.3％,发作频率减少≥50％(即总有效率)82.7％;OXC所用剂量为(26.70±6.75) ng·kg-1·d-1.其中12例成功转换为OXC单药治疗,10例单药治疗无发作.B组OXC加小剂量硝西泮药物组合治疗,发作频率减少均≥50％,疗效最高.对发作类型比较,OXC对各种局限性发作类型发作频率减少均≥50％.本研究中8例(19.5％)出现OXC相关药物不良反应,依次为困倦3例,皮疹2例,视物不清、无症状血钠减低和膝关节痛各l例,分别经缓慢加量、略减量或未进行任何处理,上述症状自行消失.结论 OXC联合用药治疗癫(癎)疗效高而稳定,耐药性小,安全性高,是适合于长期应用的新型高效抗癫(癎)药物之一.

Efficacy and Safety of Oxcarbazepine Combined with Other Anti-Epileptic Drugs in Treatment of Epilepsy in Children

Objective To explore the efficiency,dosage and safety of Oxcarbazepine(OXC) combined with other anti-epileptic drugs in treatment of epilepsy in children. Methods The study included 41 patients with epilepsy(23 male and 18 female),with a mean age of(7.70±3.25) years old(ranging from 6 months to 15 years old).Their epileptic history varies from 15 days to 5 years,with average of(9±17) months,and they were followed up for 6 months to 6 years,average of(2.5±1.6) years.The seizures were classified as simple partial seizure(SPS) in 3 cases,complex partial seizure(CPS) in 8/41 cases,secondary generalized tonic-clonic seizure(sGTCS) in 14/41 cases,SPS combined with sGTCS in 12 cases,and CPS combined with sGTCS in 4 cases.The clinical data of 41 patients with epilepsy were analyzed retrospectively and their efficiency and safety were evaluated.According to sequence of treatment with additional OXC,all the patients were divided into 2 groups(group A and group B).Patients in group A were treated with adding on OXC since their seizures were not controlled by other anti-epileptic drugs,patients in group B treated with OXC,added with other anti-epileptic drugs owing to the poor effect. Results In group A,the percentage of seizure free after adding OXC was 48.3%,while the general effective rate which the seizures frequency decreased above or equal 50% was 82.7%,the dosage of OXC was(26.70±6.75) mg·kg-1·d-1.Among group A,12 patients were successfully transformed to OXC monotherapy,and 10 patients achieved seizure free.The treatment of OXC added with a low dose of nitrazepam achieved of the highest effective rate in group B.The effective rate was all above or equal to 50% for the every type of partial seizures.The side effects of OXC were found in 8 patients,including drowsiness in 3 cases,skin rash in 2 cases,blurred vision,hyponatremia without symptom and ache of knee joint in 1 case respectively.These symptoms were relieved after increasing dosage slowly,decreasing dosage or receiving no treatment. Conclusion OXC as a combined anti-epileptic drugs therapy is effective in treatment of epilepsy and had high safety and low resistance,and it′s one of the new anti-epileptic drugs which is fit for application in long-term.