摘要
目的 研究左乙拉西坦（Levetiracetam,LEV）、拉莫三嗪（Lamotrigine,LTC）与奥卡西平（Oxcarbazepine,OXC）三种抗癫痫药物在癫痫患儿中2年的药物保留率及耐受性。方法本研究共纳入310例癫痫患儿,其中接受LEV治疗患儿145例,接受LTG治疗患儿101例,接受OXC治疗患儿64例,分析3组间药物临床疗效,记录患儿首次停药时间和原因,评估比较3组患儿12周、24周、52周、104周时的药物保留率。结果 LEV、LTC与OXC3组间药物抗癫痫疗效比较,差异无统计学意义;临床随访2年,LEV组患儿药物保留率为68.28%,LTG组为72.28%,OXC组为48.44%,3组间药物保留率比较,差异有统计学意义（P=0.002）。其中,LEV组与LTG组保留率相比,差异无统计学意义;OXC组保留率与LEV组、LTG组比较,差异均有统计学意义（P〈0.05）。3组患儿停药的主要原因为药物不良反应（47.66%）和疗效差（42.10%）,OXC组因不良反应停药患儿比例（66.77%）显著高于LEV组（36.96%）和LTG组（42.86%）,差异均有统计学意义（P〈0.05）。结论 LEV、LTG与OXC在癫痫患儿长期治疗中临床疗效相当,且LEV和LTG的药物保留率和耐受性均显著优于OXC。如无明确禁忌,癫痫患儿可优先选择LEV和LTG抗癫痫治疗。
Objective To investigate the 2-year retention rates and tolerability of levetiracetam （LEV）, Lamotrigine（LTG）, and Oxcarbazepine（OXC） in pediatric patients with epilepsy.Methods 310 pediatric patients with epilepsy were included in this study： LEV （n=145）, LTG （n=101）, and OXC （n=64）. The clinical efficacy, first discontinuation time and discontinuation reasons were recorded and compared. The retention rates at 12, 24, 52 and 104 weeks were evaluated. Results At the two-year follow up：Clinical efficacy didn＇t significantly differ among the three groups （P = 0.190）; The 2-year retention rates for LEV, LTG, and OXC, were 68.28%, 72.28%, and 48.44%, respectively （P = 0.002）. LEV and LTG had equivalent retention rates, whereas OXC retention was significantly inferior to the LEV and LTG retention （P〈0.05）. The common reasons for drug discontinuation were adverse effects （47.66%） and lack of efficacy （42.10%）, while the rate of adverse effects leading to drug withdrawal of OXC （66.77%） was higher than that of LEV （36.96%, P = 0.003） and LTG （42.86%, P = 0.023）. Conclusion These results suggested that LEV, LTG and OXC had similar clinical efficacy. LEV and LTG had comparable retention profiles and long-term tolerability in the 2-year treatment, while OXC therapy seemed to be relatively less useful. If there are no specific contradictions, pediatric patients with epilepsy could be better receiving LEV and LTG antiepileptic treatment.
出处
《中国生化药物杂志》
CAS
2017年第8期185-188,共4页
Chinese Journal of Biochemical Pharmaceutics
关键词
左乙拉西坦
拉莫三嗪
奥卡西平
癫痫
患儿
药物保留率
耐受性
levetiracetam
lamotrigine
oxcarbazepine
epliepsy
pediatric patients
drug retention rates
tolerability
