新型抗癫痫药物治疗保留率及长期耐受性的研究  

The Retention Rate of Treatment and Long-term Tolerability of the New Type of Antiepileptic Drugs

作　　者：林旭[1] 卢秀英[1] 伍雪英[1] 何进宇[1] 周东[2] 

机构地区：[1]中航工业三六三医院神经内科,成都610041 [2]四川大学华西医院神经内科

出　　处：《华西医学》2016年第2期225-229,共5页West China Medical Journal

摘　　要：目的研究5种新型抗癫痫用药(拉莫三嗪、托吡酯、奥卡西平、左乙拉西坦和加巴喷丁)治疗的保留率及耐受性。方法纳入2012年10月-2014年10月216例癫痫患者。经长程视频脑电监测确诊为癫痫的患者随机分入5个治疗组(拉莫三嗪组57例,托吡酯组42例,奥卡西平组49例,左乙拉西坦组47例,加巴喷丁组21例),分别予相应的5种药物口服治疗。每4周通过电话或面谈进行随访,记录发作的减少情况、不良反应以及放弃治疗的患者情况。按以下公式计算每次随访的保留率:当前的服药人数/该药的起始入组人数×100%。观察随访结束后,采用Kaplan-Meire生存曲线和Cox比例风险模型进行相关统计学分析。结果经过观察随访,拉莫三嗪组的最终保留率最高(85.9%)、加巴喷丁组最低(14.3%);绝大部分患者在坚持服药24周后都能坚持服药到观察结束;导致停药的常见原因依次为:无效、皮疹、镇静和行为激越不良反应。结论新型抗癫痫药物治疗保留率与药物疗效、不良反应的种类及个体耐受情况、获得药物的途径便利性、服药的个体偏好等因素相关。Objective To evaluate the treatment retention rate of five new types of antiepileptic drugs： lamotrigine（LTG）, topiramate（TPM）, oxcarbazepine（OXC）, levetiracetam（LEV） and gabapentin（GBP） and their tolerability. Methods A total of 216 patients diagnosed as epilepsy by receiving the long-term video electroencephalography monitoring between October 2012 and October 2014 were randomized into five drug treatment groups（LTG, n=57; TPM, n=42; OXC, n=49; LEV, n=47; GBP, n=21） and received corresponding dose of drug therapy. The seizure frequency, adverse events and number of patients giving up therapy were collected and recorded via phone or interview every 4 weeks. Every follow-up retention rate of every drug group equals current patient number continuing therapy/ initial patient number of this drug group×100%. When the trial ended, Kaplan-Meier curve and Cox proportional risk model were applied for statistical analysis. Results The trial lasted for 106 weeks. The final retention rate of LTG was the highest（85.9%）, and GBP was the lowest（14.3%）. Most patients could continue the therapy until the end of the trial after 24 weeks. The leading causes of discontinuing therapy included： no efficacy, rash, sedation and aggressive behavior. Conclusion The retention rate of new types of antiepileptic drugs is associated with these elements： drug efficacy, adverse events, individual tolerability of drug, drug accessibility and the patients＇ individual preference of drug administration.

关 键 词：新型抗癫痫药物 保留率 不良反应 耐受性 

分 类 号：R742.1[医药卫生—神经病学与精神病学]