拉莫三嗪在癫癎治疗中的应用  

Application of Lamotrigine on Treating Epilepsy

作　　者：李伟中[1] 谢淑霞[1] 林广裕[1] 陈派镇[1] 蔡晓莹[1] 

机构地区：[1]汕头大学医学院第二附属医院儿科,广东汕头515031

出　　处：《实用儿科临床杂志》2011年第12期962-964,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨拉莫三嗪（LTG）在儿童及青年癫癎治疗中的应用。方法对78例[男46例,女32例;年龄4个月~22岁（6.42±13.14）岁]因不同用药目的应用LTG治疗的癫癎患者治疗结果进行回顾性分析。其中LTG的维持剂量为2~8 mg.kg-1.d-1,与丙戊酸合用的维持量为1~5 mg.kg-1.d-1。结果 78例癫癎患儿单用或添加应用LTG治疗,除了3例出现药疹而停药外,其余75例坚持用药0.5 a以上。其中56例单药或添加治疗的患儿完全控制率73.21%（41/56例）、显效率10.71%（6/56例）、有效率8.93%（5/56例）、无效率7.14%（4/56例）,总有效率92.86%;11例原来癫癎控制良好但考虑原抗癫癎药物对认知损害的患儿换用LTG治疗后,4例学习成绩明显上升;另有5例原来分别以丙戊酸、卡马西平、苯巴比妥治疗的患儿分别因出现体型肥胖、血常规异常和抑郁症状而换用LTG治疗后,原来药物不良反应消失;3例进入青年期女性患儿,为避免原来药物丙戊酸可能对妊娠的致畸影响而换用LTG治疗,获得继续良好控制。78例使用LTG的药物保留率24周、48周和2 a分别为94.87%（74/78例）、84.62%（66/78例）和75.64%（59/78例）。结论 LTG除可单药或添加用于各型癫癎的治疗外,尚可用于替换其他抗癫癎药物出现不良反应的癫癎患儿的治疗,可提高长期用药患儿的生活质量。Objective To explore the application value of lamotrigine（LTG） on treating epilepsy in children and youth.Methods The curative effect of 78 patients（46 male,32 female）,aged 4 months to 22 years old[（6.42±13.14） years old]with epilepsy who took LTG for different purposes were analyzed retrospectively.LTG was used monotherapy at a maintenance dose of 2-8 mg·kg-1·d-1,and combined with valproic acid（VPA） at a maintenance dose of 1-5 mg·kg-1·d-1.Results Seventy-eight patients with epilepsy were treated with LTG monotherapy or in combination with another antiepileptic drugs（AEDs）,3 patients stopped drug induced to drug eruption in early stage,the other 75 patients all took medicines for more than 0.5 year.Forty-one out of 56 cases（73.21%） who had LTG monotherapy or as add-on therapy for adjuvant therapy had seizure-free,the total effectual rate was 10.71%（6/56 cases）,the effective rate was 8.93%（5/56 cases）,the ineffective rate was 7.14%（4/56 cases）,and the total curative efficiency was 92.86%.Eleven patients were given LTG whose epilepsy were controlled well because the previous AEDs could damage the cognitive function.And 4 cases of their academic records improved obviously.Five patients who had VPA,carbamazepine and phenobarbitone respectively changed LTG for treatment because of obesity,the abnormal blood and depressive illness.And the adverse reactions disappeared after taking LTG.Three female youth patients who had VPA pre-viously were given LTG because VPA could cause fetal deformed,and their epilepsy was good controlled as usual.The 78 patients′ retention of LTG in 24 week was 94.87%（74/78 cases）,in 48 week was 84.62%（66/78 cases）and in 2 years was 75.64%（59/78 cases）.Conclusions LTG not only can use for epilepsy as monotherapy or adjuvant therapy,but also can replace other AEDs for antiepileptic therapy when the adverse drug reactions appear,and improve the quality of life for patients with long-term drugs.

关 键 词：癫癎 拉莫三嗪 治疗 不良反应 替换 

分 类 号：R742.1[医药卫生—神经病学与精神病学]