拉莫三嗪治疗不同类型癫患儿10年开放性自身对照研究  

Open-Monotherapy Study on Different Types of Epileptic Seizures in Children Treated by Lamotrigine for 10 Years

作　　者：桂娟[1] 翟琼香[1] 张宇昕[1] 郝英[1] 詹国华[2] 

机构地区：[1]广东省人民医院儿科,广州510080 [2]广东省人民医院神经内科,广州510080

出　　处：《实用儿科临床杂志》2009年第7期533-535,共3页Journal of Applied Clinical Pediatrics

基　　金：广东省科技计划项目资助(A1999016)

摘　　要：目的评价拉莫三嗪(LTG)添加及单药治疗小儿不同类型癫的疗效及安全性。方法按1981年及1989年国际抗癫联盟的癫发作分类,将诊断为各类型癫的124例患儿分为非难治性组93例,难治性组31例。使用LTG单药或添加治疗,添加治疗者给药方法为:原抗癫药种类和剂量不变,加用LTG逐渐增加至出现发作明显减少或出现明显不良反应如皮疹、肝肾功能损害等时停止,根据治疗前3个月基线月均发作频率,将每例最后3个月的月均发作频率与基线进行比较,并观察其不良反应。结果总有效率72.6%,控制率51.6%,非难治性组总有效率81.0%,控制率61.3%,较难治组(48.4%、22.6%)明显提高。LTG与丙戊酸钠(VPA)合用组有效率78.4%,控制率54.5%,与未合用VPA组(61.0%、44.0%)比较无显著性差异(P>0.05)。病程观察期<5 a与>5 a应用LTG的疗效有显著性差异(P<0.05)。LTG与VPA合用时疗效较好,且可减少LTG剂量,不良反应主要有嗜睡、头晕等。结论LTG治疗小儿各类型癫疗效稳定,耐药性、不良反应少,是适合于长期应用的一种新型抗癫药。Objective To assess the long efficacy and safety of Lamotrigine （LTG） monotherapy and add - on therapy different types of epileptic seizures in children. Methods According to the classification of the 1981 and 1989 International Union of Antiepileptic for epileptic seizure ,a total of 124 cases with epilepsy were included in the study and divided into non -refractory group with 93 cases and refractory group with 31 cases. LTG treatment only or add - on were used. Original drug dosage was not changed and LTG was added slowly and carefully untill the terrible side effect appeared. The average monthly seizure frequency with baseline in the last 3 months was compared and the side effect was observed. Results Total efficiency was 72.6%, control rate was 51.6%. Total efficiency and control rate of the non - refractory group was 81.0% and 61.3% ,which was significantly higher than those of refractory group （48.4% ,22.6% ）. Total efficiency and control rate of the eombination group with LTG and valproate sodium （VPA） was 78.4% and 54.5% ,which was significantly higher than those of the group of LTG only （61.0% ,44.0% ）. Clinical results was different significantly between the course of the observation period within and over 5 years （ P 〈 0.05 ）. The curative effect was better when LTG was used with VPA, and it also could reduce the dose of LTG. The main side effect were lethargy and dizziness and so on. Conclusions LTG is a new type of anti - epileptic drug for long - term application which has stable efficacy with less drug resistant and less side effect in children with different types of epileptic seizures.

关 键 词：癫痫 拉莫三嗪 治疗 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]