5种抗癫痫药单药治疗新诊断癫痫患者2年保留率比较  

Comparison of Two- year Retention Rate of Five Antiepileptic Drugs Monotherapy for Patients with Newly Diagnosed Epilepsy

作　　者：李瑞杰[1] 顾家鹏 张学民[1] 王冀康 顾欣[1] 顾仁骏[1] 

机构地区：[1]新乡医学院第二附属医院神经内科,河南省新乡市453002 [2]河南省生物精神病学重点实验室

出　　处：《中国全科医学》2015年第9期1037-1041,共5页Chinese General Practice

基　　金：河南省医学科技攻关计划资助项目(201403136)

摘　　要：背景药物治疗是癫痫最主要的治疗方法,药物保留率综合反映了患者对药物治疗的认可程度,是目前常用的评价指标。近年有关抗癫痫药(AEDs)保留率的研究多数为短期保留率,因此探索常用AEDs的长期保留率具有重要的临床意义。目的比较5种AEDs单药治疗新诊断癫痫患者的2年保留率。方法选取1993年1月—2012年1月新乡医学院第二附属医院神经内科新诊断的癫痫患者736例,分别接受卡马西平(CBZ)、丙戊酸(VPA)、托吡酯(TPM)、奥卡西平(OXC)或拉莫三嗪(LTG)单药治疗,并分为CBZ组、VPA组、TPM组、OXC组、LTG组。通过门诊和电话随访,记录患者保留率、临床疗效、不良反应及停药原因。结果 2年时736例患者中有560例患者仍保留原药物单药治疗,总保留率为76.1%,其中LTG保留率为85.9%(67/78)、OXC为78.6%(44/56)、TPM为77.7%(80/103)、VPA为74.4%(218/293)、CBZ为73.3%(151/206)。LTG保留率与CBZ、VPA保留率比较,差异有统计学意义(P<0.05);其他药物之间比较,差异均无统计学意义(P>0.05)。5组儿童癫痫患者AEDs单药2年保留率比较,差异有统计学意义(P<0.05);5组成人癫痫患者AEDs单药2年保留率比较,差异无统计学意义(P>0.05)。2年后5组临床疗效比较,差异无统计学意义(H=7.426,P=0.115)。停药的首要原因是依从性差,其次是无效。结论 LTG单药治疗的2年保留率最高,5组药物间的临床疗效无差别,停药原因主要是依从性差,此结果将对我国癫痫患者的临床治疗提供参考依据。Background Drug therapy is the major treatment of epilepsy. As a common evaluation index,the drug retention rate comprehensively reflects the extent of patient＇ s recognition to the drug therapy. The recent studies were mostly focused on short- term retention rate of anti- epileptic drugs（ AEDs）,it is important to explore the long- term retention rate of AEDs. Objective To compare the two- year retention rate of five AEDs monotherapy for patients with newly diagnosed epilepsy. Methods 736 cases with nwely diagnosed epilepsy who were treated in Department of Neurology of the Second Affiliated Hospital of Xinxiang Medical University from January 1993 to January 2012, were selected as study subjects, they received carbamazepine（ CBZ）, valproic acid（ VPA）, topiramate（ TPM）, oxcarbazepine（ OXC） and lamotrigine（ LTG）monotherapy,respectively,divided to CBZ group, VPA group, TPM group, OXC group and LTG group. The informations such as retention rate, epileptic seizure, adverse reactions and the reasons for drug withdrawal were obtained by means of outpatient follow- up and telephone follow- up. Results After two years of treatment, among 736 cases,560 cases still received the original drug monotherapy,the total retention rate was 76. 1%,the retention rate of LTG,OXC,TPM,VPA,and CBZ was 85. 9%（ 67 /78）, 78. 6%（ 44 /56）, 77. 7%（ 80 /103）, 74. 4%（ 218 /293） and 73. 3%（ 151 /206）,respectively. The retention rate of LTG was significantly different from that of CBZ and VPA,respectively（ P〈0. 05）,there was no significant difference in the retention rate among the other drugs（ P〉0. 05）. There were significant differences in two- year retention rate of AEDs monotherapy among five groups of pediatric epileptic patients（ P〈0. 05）; there was no significant difference in two- year retention rate of AEDs monotherapy among five groups of adult epileptic patients（ P〉0. 05）. After two years of treatment,there was no significant difference in the clinical curative effec

关 键 词：抗惊厥药 癫痫 保留率 

分 类 号：R742.1[医药卫生—神经病学与精神病学]