不同抗癫痫药物对新诊断癫痫患者一年保留率的回顾性研究  

One year retention rate of first-line antiepileptic drugs as an initial monotherapy in patients with newly diagnosed epilepsy

作　　者：杨丰[1] 崔小丽[1] 刘养凤[1] 王莹[1] 高飞[1] 景芸芸[1] 康小刚[1] 江文[1] 

机构地区：[1]第四军医大学西京医院神经内科

出　　处：《中国神经精神疾病杂志》2011年第6期362-365,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：教育部新世纪优秀人才支持计划(编号:NCET-07-0146)

摘　　要：目的比较几种一线抗癫痫药物单一治疗对新诊断癫痫患者的保留率。方法我们利用门诊随访的方式,对284名新诊断癫痫患者首次使用单一抗癫痫药物治疗进行回顾性研究,采用多样本率的卡方分割法,对单一抗癫痫药的一年保留率进行分析。结果最常见的一线抗癫痫药为丙戊酸钠(70例,24.6%),拉莫三嗪(59例,20.7%),卡马西平(56例,19.7%),奥卡西平(48例,16.9%),托吡酯(35例,12.3%)。一年保留率依次为拉莫三嗪(93.2%),奥卡西平(72.9%),托吡酯(65.7%),卡马西平(62.5%),丙戊酸钠(65.7%)。拉莫三嗪的一年保留率,与奥卡西平相比较,无统计学差异(P=0.08),与卡马西平(P=0.00089)、丙戊酸钠(P=0.00027)和托吡酯(P=0.018)相比,具有统计学差异。其他药物之间无明显统计学差异(P=0.315)。结论拉莫三嗪治疗新诊断癫痫患者的一年保留率最高。深入研究新诊断癫痫患者的首次抗癫痫药物保留率,将对我国癫痫患者的临床治疗提供更详细、准确的指导。Objective To assess the retention rate of first-line antiepileptic drugs as an initial monotherapy in Chinese patients with newly diagnosed epilepsy. Methods Hospital records were reviewed for 284 patients who were newly diagnosed with epilepsy, or started on the first antiepileptic drug, and then monitored for more than 1 year. Results Of the 284 patients analyzed, the mean age was 17.2 ± 11.8 years at diagnosis. Most of the patients suffered from focal seizures including secondary generalized seizure （n：l51,66. 2% ）. 96 patients （33.8%） were classified as having generalized seizure. Valproic acid （VPA; n： 70, 24. 6% ）, lamotrigine（LTG; n： 59, 20.7% ）, carbamazepine （CBZ; n： 56, 19. 7% ） and oxcarbazepine （OXC; n： 48, 16. 9% ） were the most frequently first antiepileptic drugs. Overall, at 1 year, retention rate was highest with LTG （93.2%）, followed by OXC （72. 9% ）, VPA （65.7%）, TPM （65.7%）, CBZ （62. 5% ）. The highest retention rate with LTG, which was significantly different from VPA （ P = 0. 00027 ） , CBZ （ P = 0. 00089 ） , TPM （P = 0. 018 ）. There was no statistically significant different retention rate between LTG and OXC （P = 0. 08 ）. And, no difference in retention rates was found among the other AEDs （P = 0. 315 ） in our patients with newly diagnosed epilep- sy. Conclusions In this study, LTG had highest retention rate. Comparing retention rates of first AEDs can provide useful insight into the first antiepileptic drug therapy in patients with newly diagnosed epilepsy.

关 键 词：新诊断癫痫 保留率 抗癫痫药物 

分 类 号：R742.1[医药卫生—神经病学与精神病学]