托吡酯治疗小儿癫癎66例临床分析  

Topiramate in the treatment of pediatric epilepsy:a 66-case report

作　　者：孙道开[1] 王艺[1] 陈天兰[1] 邱鹏玲[1] 周水珍[1] 金佩娟[1] 

机构地区：[1]复旦大学附属儿科医院,上海200032

出　　处：《中国实用儿科杂志》2001年第6期356-358,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　观察托吡酯单药或添加治疗治疗小儿癫疒间。方法　观察部分性发作及继发性全身性发作 17例 ,Lennox Gastaut综合征 31例 ,West综合征 18例 ,对其中已应用传统抗癫疒间 药物治疗控制不理想的病例添加托吡酯治疗 ,而对新诊断病例应用托吡酯单一治疗 ,进行自身对照的开放性研究。结果　①托吡酯治疗小儿癫疒间6 6例 ,平均疗程 6个月 ,其总的疗效为发作减少≥ 5 0 %占 48例 (72 .7% ) ,发作减少≥ 75 %占 36例 (5 4.5 % ) ,发作控制 2 7例 (40 9% )。②托吡酯治疗部分性发作及继发性全身性发作 17例发作减少≥ 5 0 %为 15例 (88% ) ,发作减少≥ 75 %为 11例 (5 1.6 % ) ,发作消失为 9例 (5 2 .9% ) ;Lennox Gastaut综合征组 31例发作减少≥ 5 0 %为 2 0例(6 4.5 % ) ,发作减少≥ 75 %为 16例 (5 1.6 % ) ,发作消失为 12例 (38.7% ) ;West综合征组 18例发作减少≥ 5 0 %为13例 (72 % ) ,发作减少≥ 75 %为 9例 (5 0 0 % ) ,发作消失为 6例 (33.3% )。③添加托吡酯治疗对卡马西平和丙戊酸钠的添加治疗前后的血浓度没有明显影响。④不良反应 :嗜睡 14例 (2 1.2 % )、反应淡漠 4例 (6 .0 % )、纳差 17例 (2 5 .7% )、类暑热症 4例 (6 .0 % )。结论　托吡酯对部分性发作及继发性全身性发作、LennoxObjective To observe the effect of Tipiramate(TPM)in the treatment of pediatric epilepsy.Methods\ 17 patients with partial seizures,18 West syndrome and 31 Lennox Gastaut syndrome were enrolled in this study.The study was designed as self controlled,open labeled research.And TPM was administered to all the patients,either as mono or add on therapy.Results\ ①48 patients(72 7%)had 50%,36(54 5%)had 75% reduction in attack and 27 patients(40 9%)with no attack occured.②In 17 patients with partial seizure,15(88%)had 50% and 11(51.6%)had 75% reduction in attack.In 18 Lennox Gastant Syndrome,13(64 5%)had 50%,16(51.6%)had 75% reduction in attack and 12(40.4%)with no attack occurred.In 18 West Syndrome,13(72%)had 50%,9(50%)had 75% reduction in attack and 6(33.3%) with no attack occurred.③Serum concentrations of valproic acid and cabarmazepine were not affected obviously by TMP therapy.④Adverse reaction:Lethargy occurred in 14 patients(21.2%),apathy in 4(6.0%),dyspepsia in 17(25.7%)and summer fever-like syndrome in 4(6.9%).Conclusion\ TMP,which was safe and slight adverse reactioned,was effective treating the patients with partial seizures,Lennox Gastant Syndrome and West Syndrome.

关 键 词：托吡酯 癫痫 儿童 药物治疗 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R971.6[医药卫生—临床医学]