不同撤药时机对癫痫患者复发的影响  

Early versus late antiepileptic drugs withdrawal for patients with seizure-free epilepsy

作　　者：苏凌璎[1] 狄晴[1] 余年[1] 张燕芳[1] 王凌玲[1] 

机构地区：[1]南京医科大学附属脑科医院神经内科,南京210029

出　　处：《中华神经医学杂志》2012年第10期982-985,共4页Chinese Journal of Neuromedicine

基　　金：江苏省南京市医学科技发展重大项目（2007-0211）

摘　　要：目的 探讨不同撤药时机对癫痫患者复发的影响。方法 前瞻性收集至少达2年无发作而撤药的癫痫患者的临床资料，根据撤药时机分为早期撤药组（达2-3年缓解期1及晚期撤药组（〉3年缓解期）。自撤药开始，撤药后复发者随访至复发时止，未复发者至少随访2年。采用Kaplan-Meier生存分析法比较不同撤药时机对癫痫患者撤药后复发的影响；同时观察2组患者撤药后不同随访时间点的复发率。结果 共收集76例年龄6～67岁的撤药癫痫患者，平均随访（2．0±1．5）年。其中早期和晚期撤药组各38例患者。至随访终点，76患者累积复发率为51．6％；2组患者撤药至复发时间差异无统计学意义（P〉0．05）；早期和晚期撤药组患者撤药后3、6、12、24个月癫痫复发率分别为13．2％ vs 7．9％、34．2％ vs 13．2％、42．1％ vs 42．1％、51．4％ vs 52．6％，差异均无统计学意义（P〉0．05）：仅在随访6个月时2组复发率差异有统计学意义（P〈0．05）。结论 癫痫患者≥2年无发作后可考虑撤药。Objective To explore the influences of early and deferred antiepileptic drugs （AEDs） withdrawal in relapse of epilepsy. Methods Patients with seizure-free epilepsy at least for 2 years were collected and followed-up prospectively until relapse occurred or at least for 2 years. They were divided into early （2 to 3 seizure free years） and late （more than 3 seizure free years） AEDs withdrawal groups according to the timing of AEDs withdrawal. Kaplan-Meier survive statistics was used to analyze the time of seizure relapse after early/late AEDs withdrawal. Their cumulative recurrence rate at different times of follow-up was observed and compared. Results Seventy-six epileptic patients aged 6-67 years （38 in the early withdraw group and 38 in the late withdraw group） were collected; they were followed up for a mean of（2.0±1.5） years. Till the end of the follow up, the cumulative recurrence rate for 76 patients was 51.6%; no statistical difference of cumulative recurrence rate from withdraw time to seizure relapse was noted between early and late withdrawal groups （P〉0.05）. The recurrence rates at 3, 6, 12 and 24 months of follow-up in the early and late withdrawal groups were 13.2% vs 7.9% （P〉 0.05）, 34.2% vs 13.2% （P〉0.05）, 42.1% vs 42.1% （P〉0.05） and 51.4% vs 52.6% （P〉0.05）, respectively; significant difference could only be noted at 6 months of follow-up （P〈0.05）. Conclusion AEDs withdrawal can be considered for patients with seizure-free epilepsy for more than 2 years.

关 键 词：癫痫 撤药时机 复发 

分 类 号：R742.1[医药卫生—神经病学与精神病学]