左乙拉西坦单药或添加治疗癫痫的临床观察

目的观察左乙拉西坦单药和添加治疗癫痫的临床疗效和不良反应。方法对91例门诊癫痫患者进行左乙拉西坦开放性治疗;其中少儿组54例,成人组37例;简单部分性发作(SPS)19例,复杂部分性发作(CPS)20例,全面性强直阵挛性发作(GTCS)32例,继发性全面性强直阵挛性发作(sGTCS)20例;采用单药治疗66例,添加治疗25例。左乙拉西坦起始剂量即为治疗剂量,儿童为10 mg/(kg.d),成人为0.5～3.0 g/d;治疗6个月时根据发作频率自身对照评价疗效,观察不良反应。结果治疗6个月时本组癫痫控制率为52.7%(48例),总有效率为75.8%;少儿组控制率和总有效率分别为64.8%及90.7%,明显高于成人组(35.1%,54.1%;均P<0.01);单药治疗组分别为62.1%及81.8%,明显高于添加治疗组(28.0%,60.0%;均P<0.01);SPS、CPS和GTCS的控制率分别为68.4%和55.0%及53.1%,明显高于sGTCS(35.0%,均P<0.01);SPS控制率明显高于GTCS(P<0.05)。本组不良反应发生率为16.5%,多较轻微,2例因明显脱发而换药。结论左乙拉西坦对多种类型的癫痫发作具有较好的疗效,对儿童及单药治疗的患者疗效更好;儿童及成人患者均有较好的耐受性。

Clinical observation of Levetiracetam for single or add-on therapy on epilepsy

Objective To observe the curative effect and adverse reaction of Levetiracetam for single or add-on therapy on epilepsy.Methods Levetiracetam open treatment was dong in 91 outpatient patients with epilepsy,including child group 54 cases and adult group 37 cases.Among them,there were simple partial seizure(SPS)in 19 cases,complex partial seizure(CPS)in 20 cases,generalized seizures(GTCS)in 32 cases and partial seizure evolving to secondarily generalized seizures(sGTCS)in 20 cases.The 66 cases received single therapy and 25 cases received add-on therapy.The starting dose of Levetiracetam was the therapeutic doses,which was 10 mg/(kg·d) in children,and 0.5-3.0 g/d in adult.The curative effect was evaluated according to the seizure frequency self-reflection after 6 months of Levetiracetam therapy.The adverse reaction was observed.Results After 6 months of the therapy,the control rate was 52.7%(48 cases),and the total effective rate was 75.8%.The control rate and the total effective rate in child group were 64.8% and 90.7% respectively,which were significantly higher than adult group(35.1%,54.1%;all P<0.01);and which in single therapy group(62.1%,81.1%) were significantly higher than add-on therapy group(28.0%,60.0%;all P<0.01).The control rate in SPS(68.4%),CPS(55.0%) and GTCS(53.1%) were significantly higher than sGTCS(35.0%,all P<0.01).The control rate in SPS was significantly higher than GTCS(P<0.05).The incidence of adverse reactions was 16.5% in this study,and mostly was milder;but there were 2 cases stop the therapy because alopecia.Conclusions Levetiracetam is better effective for various types epilepsy seizures with good tolerance for children and adult;and especialy for children and patient who take single therapy.