托吡酯治疗小儿难治性癫部分性发作36例  

An Appraisal of the Curative Effect of Topiramate in the Treatmant of Refractory Partial-onset Epilepsy in Children

作　　者：王大斌[1] 明萌[1] 齐旭升[1] 王勇[1] 刘新 

机构地区：[1]郧阳医学院附属太和医院儿童医疗中心,湖北十堰442000

出　　处：《医药导报》2007年第2期156-158,共3页Herald of Medicine

摘　　要：目的研究托吡酯治疗小儿难治性癫痫部分性发作的疗效与安全性。方法36例难治性癫痫部分性发作患儿，原来使用的抗癫痫药种类和剂量不变，将托吡酯作为辅助治疗药物，从0．5mg·kg^-1·d^-1开始，每周增加0．5mg·kg^-1·d^-1，目标剂量4．0～9．0mg·kg^-1·d^-1，根据癫痫发作情况调整托吡酯剂量。癫痈发作被控制后，原用抗癫痫药物逐渐减量直至停用。结果实验过程中2例失访，2例因不良反应退出观察，其他患儿治疗6个月后，总有效率78．0％，同治疗前比较，总发作频率减少73．0％（P〈0．01），其中简单部分性发作频率减少79．0％（P〈0．05），复杂部分性发作频率减少71．0％（P〈0．05），部分性发作全身泛化发作频率减少67．0％（P〈0．01）。治疗至6个月末心电图及肝、肾功能，血、尿常规均未见明显异常。11例患儿在加量期出现轻、中度不良反应，不需特殊处理大多可自行消失。结论托吡酯治疗小儿难治性癫痫部分性发作疗效确切，安全性高，患儿耐受好。Objective To study the curative effect and safeness of topiramate in the treatment of refractory partial-onset epilepsy in children. Methods 36 patients with childhood refractory partial-onset epilepsy were enrolled in the study. The kinds and dosages of antiepileptics formerly used by the patients remained unchanged in the present study. Topiramate was then used as an additive remedy, beginning with a dose of 0.5 mg ·kg^-1·d^-1 per os. The dose was increased by 0.5 mg ·kg^-1·d^-1 every week, aiming at a final dose of 4.0 -9.0 mg ·kg^-1·d^-1. When, however, obvious curative effects appeared, the gradual increase in the dosage of the drug was stopped and the dosage on that very day was taken as the maintenance dose thereafter. The antiepileptics formerly used by the patients were given in gradually decreasing doses followed by discontinuation of the drugs after the epilepsy had been controlled. Results The overall effective rate in the 36 patients after 6 months of treatment was 78. 0%. In comparison with the status before the treatment, the total seizure frequency was decreased by 73.0% （P 〈 0.01 ）. Among these, the simple partial seizure （SPS） frequency was decreased by 79.0% （P 〈0.05）, complex partial seizure （CPS） frequency was decreased by 71.0% （P 〈 0.05 ） , and second generalized seizure SGS seizure frequency was decreased by 67.0% （P〈0.01）. At the termination of the 6-month treatment, no overt anomalies were demonstrated by ECG, liver and kidney function tests and routine examinations of the blood and urine. Mild to moderate adverse reactions were encountered in 11 patients when the doses of topiramate were steadily increased. These reactions usually disappeared spontaneously demanding no particular managements. Conclusion Topiramate was shown to exert definite curative effects in the treatment of refractory partial-onset epilepsy, in children. It was also fairly safe and well-tolerated by the patients.

关 键 词：托吡酯 癫痫 难治性 部分性发作 

分 类 号：R971.6[医药卫生—药品] R742.1[医药卫生—药学]