摘要
目的 观察妥泰 ( TPM)添加治疗儿童癫痫的疗效及癫痫发作完全控制后转换为 TPM单药治疗的可行性。方法 对 94例应用一线抗癫痫药控制不满意的患儿 ,其中部分性发作 ( PS) 5 2例 ,全身性发作 ( GS) 4 2例 ,在原用抗癫痫药 ( AEDs)的基础上加用 TPM 0 .5～ 1.0 mg/ kg.d,日 2次 ,口服 ,每 5～ 7d加量一次 ,直至达到目标剂量。治疗 12周后根据发作频率将疗效分为完全控制、显效、有效和无效。对发作完全控制后的癫痫患儿 8～ 12周后 ,逐渐减去其它抗癫痫药 ,转换为 TPM单药治疗。结果 5 2例 PS患儿应用 TPM治疗后得到完全控制 2 9例 ,显效 10例 ,有效 6例 ,无效 7例 ,总有效率为 86 .5 %;42例 GS患儿治疗后完全控制 16例 ,显效 9例 ,有效 8例 ,无效9例 ,总有效率为 78.6 %;在完全控制发作的 2 9例 PS中 ,及 GS的 16例中 ,转换为单用 TPM治疗达 2个月以上尚未见发作的分别为 7例、4例。94例加用 TPM后 2 9例出现的不良反应 ,占 30 .9%,其中以食欲减退多见 ,其次为困倦及体重下降等 ,在加量期过后大多消失 ,治疗前后血、尿常规、肝、肾功能未发现有临床意义的改变。结论 TPM是一种广谱、高效、安全的 AEDs,适用于小儿各型癫痫的联合和单药治疗。
Objective To investigate the effect of add-on therapy of TPM and the possibility of changing to monotherapy after complete control.Methods In 94 cases uncontrolled by the first line of anti-epileptic drugs,52,partial seizure(PS)and 42,generalized seizure(GS)were treated by add-on oral TPM , 0.5～1.0mg/kg·d,bid.The dosage was enhanced timely every 5 to 7 days until attaining the objective dose.Patients were divided into completely controlled,singnificantly effective,effective and invalid group after 12 weeks of TPM therapy.In those completely controlled,8～12 weeks later,other anti-epileptic drugs were gradually withdrawed,and then changed to the mono-TPM therapy.Results Of 52 cases of PS,29 were completely controlled,10 significantly effective,6 effective,7 invalid,respectively;the total effective rate was 86.5%.Of 42 GS,16 were completely controlled,9 siginficantly effective,8 effective,9 invalid,respectively;the total effective rate was 78.6%.Of 29 PS and 16 GS completely controlled and changed to monotherapy,7 and 4 respectively were achieved successfully,without recurrent seizure over 2 months.29 of 94 cases added with TPM appeared side effects,accounting for 30.9%,including appeptide losing,dizzy and weight decrease.Those side effects disappeared after add-on stage.There were no changes in examinations,such as blood routine,urine routine,liver function and renal function test.Conclusion TPM,as a kind of grand spectrum,highly effective and safe anti-epileptic drugs,is appropriated to all kinds of childhood epilepsy by add-on or monotherapy.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2003年第2期123-125,共3页
Journal of Apoplexy and Nervous Diseases
关键词
妥泰
药物转换
治疗
儿童
癫痫
疗效观察
Topamax
Epilepsy
Add-on therapy
Monotherapy
Side effect
