社区人群癫癎患者抗癫癎治疗现状及效果分析  

Analysis of the therapeutic effect and current situation of antiepileptic therapy in patients with epilepsy in community population

作　　者：黄茂盛[1] 洪震[1] 曾军 吕传真 戎雪宝 盛雨田 

机构地区：[1]复旦大学附属华山医院神经病学研究所 [2]上海市金山区老年护理医院 [3]上海市金山区朱泾地区地段医院

出　　处：《临床神经电生理学杂志》2002年第3期137-139,共3页Journal of Clinical Electroneurophysiology

摘　　要：目的 :研究社区人群癫患者药物治疗现状及影响其效果的主要因素。方法 :于 2 0 0 0年在上海市金山朱泾镇采用分层整群抽样完成 5万人群的癫普查 ,并对癫患者进行药物治疗现状调查和对服药者的血药浓度进行测定。结果 :癫患病率为 3 11‰ ,标化患病率为 3 6 2‰。癫患者中从未服药者 33 1% ,曾服药者 6 6 9% ,目前正在服药者占 35 6 % ,以单药治疗为主。治疗后显效者5 1 5 % ,有效者 4 0 6 % ,无效或恶化者 7 9%。服用单药者显效和有效的比例明显高于服用二种药或三种药的效果。服药者血药浓度在有效范围者 ,仅占 36 1% ,其中服用苯巴比妥者血药浓度达标的比例(71 4 % ) ,明显高于其他药物。血药浓度在有效范围内的显效率为 5 3 3% ,明显高于未达有效范围者的显效率 (2 3 8% )。非条件Logistic回归分析显示与治疗效果有关的主要因素为病程、发作年龄、现年龄、发作频率、教育程度、服药类型、血药浓度等。结论 :社区人群癫患者接受治疗的比例和服药后血药浓度达有效范围的比例都较低。Objective: To investigate the pharmaceutical therapy condition and the main factors affecting the therapeutic effect of epileptic patients in Community Population . Methods: Epilepsy census by means of Stratified cluster sampling has been carried out in 50000 people in Zhujing Town , Jingshan District , Shanghai in 2000,and the pharmaceutical therapy condition was investigated . The blood pharmaceutical concentration of drug-taken patients was determined .Results : The epilepsy crude prevalence was 3.11‰ and the standardized prevalence was 3.62‰. In all epilepsy patients ,those who never take medicine was 33.1% and those who took medicine occupy 66.9% , and those who are taking medicine occupy 35.6%(mainly taking only one kind of drugs). After pharmaceutical therapy , 51.5% of patients showed significant effect, and 40.6% of them was effective , the other 7.9% showed no effect or deterioration .The ratio of significant effect and having effect in patients taking only one drug was remarkably higher than that in those who take 2 or 3 kinds of drugs . The drug-taken patients whose blood drug concentration was in the range of having effect only occupied 36.1% . The ratio of patients who took phenobarbital and the blood drug concentration reach the criteria was the highest (71%), significantly higher than that of patients taking other drugs . The rate of showing good effect in patients whose blood drug concentration was in the range of effect was 53.3% , remarkably higher than that in patients whose blood drug concentration didn't reach the effective concentration . A multiple logistic regression showed that the course of disease , the age of onset , the current age , the seizure frequency , the degree of education , the type of drugs and the blood drug concentration were the main factors affecting the therapeutic effect . Conclusion : Both the ratio of epileptic patients receiving therapy and the ratio of patients whose blood drug concentration reach the effective range might be lower in community population . T

关 键 词：社区人群 癫痫 抗癫痫治疗 现状 效果分析 

分 类 号：R742.1[医药卫生—神经病学与精神病学]