摘要
目的系统评价左乙拉西坦(LEV)治疗老年性癫痫(SE)的疗效。方法检索近10年Cochrane Library、Medline、Pubmed、Web of Science、万方数据库、维普中文科技期刊全文数据库、中国学术期刊全文数据库,对纳入研究的方法学进行评价。研究者对纳入文献的质量进行严格评价和资料提取,使用Review manager 5.0软件对符合质量标准的RCT行系统评价。结果 6个RCT共283名患者纳入研究,其中治疗组(使用左乙拉西坦)144例,对照组(使用拉莫三嗪、托吡酯、奥卡西平、加巴喷丁等药物)139例,2组患者均行常规对症支持治疗。系统评价结果表明:3个月内癫痫发作次数比较,治疗组优于对照组(RR=-1.40,95%CI为-1.73～-1.08,P<0.01);6个月内癫痫发作次数比较,治疗组优于对照组(RR=-2.07,95%CI为-2.44～-1.70,P<0.01);6个月内肝功能受损人数比较,治疗组优于对照组(RR=0.39,95%CI为0.19～0.84,P<0.01);6个月内肾功能受损人数比较,治疗组优于对照组(RR=0.36,95%CI为0.15～0.84,P<0.01);6个月内因神经系统疾病死亡人数比较,2组差异无统计学意义(RR=1.06,95%CI为0.64～1.77,P>0.05)。不良反应为粒细胞减少(治疗组仅3例),皮疹(对照组3例),差异无统计学意义。结论使用LEV可提升SE的疗效,并且不增加患者因神经系统疾患死亡的风险。
Objective To evaluate the efficacy of levetiracetam in the treatment of senile epilepsy.Methods Nearly 10 years data were search by Cochrane Library,Medline,PubMed,Web of Science,CECDB,CQVIP,CNKI,included evaluation study.Researchers critical appraisal,data extraction and quality of included studies,Evaluation review were managed by software 5.0 on the RCT line systems that meet quality standards.Results 6 RCT of 283 patients were included in this study,the treatment group（use LEV）of 144 cases,control group（use LTG,TPM,OXC,GBP）of 139 cases.Two groups of patients also were given the symptomatic supportive treatment.Systematic reviews results showed that there were significant differences of the number of seizures in patients within 3 months（RR=-1.40,95%CI-1.73 ^-1.08,P 0.01）and 6 months（RR=-2.07,95%CI-2.44～-1.70,P 0.01）between the treatment group and control group.The number of patients with impaired liver function（RR=0.39,95%CI 0.19 ~ 0.84,P 0.01）and kidney function（RR=0.36, 95%CI 0.15～0.84,P 0.01）within 6 months also were statistical different between the two groups.No significant difference was found between 2 groups in mortality rate（RR=1.06,95%CI 0.64 ~ 1.77,P 0.05）.Conclusion Levetiracetam can significantly improve the efficacy of treating senile epilepsy,and does not increase the risk of death in patients with nervous system disorders.
出处
《疑难病杂志》
CAS
2013年第1期5-9,共5页
Chinese Journal of Difficult and Complicated Cases
