左乙拉西坦、拉莫三嗪与奥卡西平在癫痫患儿中两年保留率及耐受性比较  

Study on the two-Year retention rates and long-term tolerability of Levetiracetam, Lamotrigine, and Oxcarbazepine in pediatric patients with epilepsy

作　　者：王珊丹[1] 杨昕[1] 

机构地区：[1]山东大学第二医院小儿内科,山东济南250000

出　　处：《中国生化药物杂志》2017年第8期185-188,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的 研究左乙拉西坦（Levetiracetam,LEV）、拉莫三嗪（Lamotrigine,LTC）与奥卡西平（Oxcarbazepine,OXC）三种抗癫痫药物在癫痫患儿中2年的药物保留率及耐受性。方法本研究共纳入310例癫痫患儿,其中接受LEV治疗患儿145例,接受LTG治疗患儿101例,接受OXC治疗患儿64例,分析3组间药物临床疗效,记录患儿首次停药时间和原因,评估比较3组患儿12周、24周、52周、104周时的药物保留率。结果 LEV、LTC与OXC3组间药物抗癫痫疗效比较,差异无统计学意义;临床随访2年,LEV组患儿药物保留率为68.28%,LTG组为72.28%,OXC组为48.44%,3组间药物保留率比较,差异有统计学意义（P=0.002）。其中,LEV组与LTG组保留率相比,差异无统计学意义;OXC组保留率与LEV组、LTG组比较,差异均有统计学意义（P〈0.05）。3组患儿停药的主要原因为药物不良反应（47.66%）和疗效差（42.10%）,OXC组因不良反应停药患儿比例（66.77%）显著高于LEV组（36.96%）和LTG组（42.86%）,差异均有统计学意义（P〈0.05）。结论 LEV、LTG与OXC在癫痫患儿长期治疗中临床疗效相当,且LEV和LTG的药物保留率和耐受性均显著优于OXC。如无明确禁忌,癫痫患儿可优先选择LEV和LTG抗癫痫治疗。Objective To investigate the 2-year retention rates and tolerability of levetiracetam （LEV）, Lamotrigine（LTG）, and Oxcarbazepine（OXC） in pediatric patients with epilepsy.Methods 310 pediatric patients with epilepsy were included in this study： LEV （n=145）, LTG （n=101）, and OXC （n=64）. The clinical efficacy, first discontinuation time and discontinuation reasons were recorded and compared. The retention rates at 12, 24, 52 and 104 weeks were evaluated. Results At the two-year follow up：Clinical efficacy didn＇t significantly differ among the three groups （P = 0.190）; The 2-year retention rates for LEV, LTG, and OXC, were 68.28%, 72.28%, and 48.44%, respectively （P = 0.002）. LEV and LTG had equivalent retention rates, whereas OXC retention was significantly inferior to the LEV and LTG retention （P〈0.05）. The common reasons for drug discontinuation were adverse effects （47.66%） and lack of efficacy （42.10%）, while the rate of adverse effects leading to drug withdrawal of OXC （66.77%） was higher than that of LEV （36.96%, P = 0.003） and LTG （42.86%, P = 0.023）. Conclusion These results suggested that LEV, LTG and OXC had similar clinical efficacy. LEV and LTG had comparable retention profiles and long-term tolerability in the 2-year treatment, while OXC therapy seemed to be relatively less useful. If there are no specific contradictions, pediatric patients with epilepsy could be better receiving LEV and LTG antiepileptic treatment.

关 键 词：左乙拉西坦 拉莫三嗪 奥卡西平 癫痫 患儿 药物保留率 耐受性 

分 类 号：R748[医药卫生—神经病学与精神病学]