左乙拉西坦与地西泮间歇短期预防小儿热性惊厥复发的疗效及安全性  

Investigation on the Efficacy and Safety of Levetiracetam and Diazepam in Intermittent Short-term Prevention of Febrile Seizure Recurrence in Children

作　　者：张方园 杨晓丽[2] 杨燕飞 ZHANG Fangyuan;YANG Xiaoli;YANG Yanfei(Department of Pediatric Medicine,Shanxi Medical University,Taiyuan 030001,China;Department of Pediatrics,Shanxi Provincial People′s Hospital,Taiyuan 030012,China;Department of Pediatrics,Shanxi Bethune Hospital,Taiyuan 030031,China)

机构地区：[1]山西医科大学儿科医学系小儿内科教研室,太原030001 [2]山西省人民医院儿科,太原030012 [3]山西白求恩医院儿科,太原030031

出　　处：《医学综述》2020年第19期3926-3930,共5页Medical Recapitulate

摘　　要：目的探讨左乙拉西坦(LEV)与地西泮用于间歇短期预防小儿热性惊厥复发的临床疗效及安全性。方法选取2017年9月至2018年8月在山西白求恩医院儿科就诊的92例反复发作热性惊厥患儿为研究对象,采用随机数字表法分为对照组(常规对症治疗,n=23)、地西泮组(常规对症治疗+地西泮,n=22)、低剂量LEV组(常规对症治疗+小剂量LEV,n=24)和高剂量LEV组(常规对症治疗+大剂量LEV,n=23)。比较随访期间四组患儿发热次数、惊厥复发次数、惊厥复发例数、惊厥持续时间、不良反应以及癫痫发生率。结果四组发热次数比较差异无统计学意义(P>0.05),地西泮组、低剂量LEV组和高剂量LEV组惊厥复发次数、惊厥复发比例、惊厥持续时间均低于对照组(P<0.05),而三组组间比较差异无统计学意义(P>0.05)。地西泮组乏力、头晕及食欲减退4例,轻度嗜睡4例,不良反应发生率为36.36%(8/22);低剂量LEV组轻度嗜睡1例,不良反应发生率为4.17%(1/24);高剂量LEV组轻度嗜睡1例,兴奋、脾气暴躁1例,不良反应发生率为8.70%(2/23)。三组不良反应发生率比较差异有统计学意义(P<0.05),地西泮组不良反应发生率高于低剂量LEV组和高剂量LEV组(P<0.05)。对照组、地西泮组、低剂量LEV组和高剂量LEV组癫痫发生率分别为0(0/23)、0(0/22)、0(0/24)、4.35%(1/23),四组癫痫发生率比较差异无统计学意义(P>0.05)。结论地西泮和LEV均可有效预防热性惊厥的反复发生;小剂量LEV可预防热性惊厥复发,且LEV不良反应较少,安全性高。Objective To investigate the clinical efficacy and safety of levetiracetam(LEV)and diazepam in intermittent short-term prevention of febrile convulsion recurrence in children.Methods A total of 92 children with recurrent febrile seizures admitted to the Department of Pediatrics of Shanxi Bethune Hospital from Sep.2017 to Aug.2018 were randomly assigned to a control group(conventional treatment,n=23),a diazepam group(conventional treatment+diazepam,n=22),a low-dose LEV group(conventional treatment+low-dose LEV,n=24)and a high-dose LEV group(conventional treatment+high-dose LEV,n=23).During the follow-up period,the frequency of fever,the frequency of convulsion recurrence,the number of cases of convulsion recurrence,the duration of convulsion recurrence,the incidence of adverse reactions and the incidence of epilepsy of the four groups were compared.Results There was no significant difference in fever frequency among the four groups(P>0.05),the frequency,number and duration of convulsions in the diazepam group,low-dose LEV group and high-dose LEV group were lower than those in the control group(P<0.05),but there was no significant difference among the three groups(P>0.05).In the diazepam group,there were 4 cases of asthenia,dizziness and anorexia,4 cases of mild somnolence,and the incidence of adverse reactions was 36.36%(8/22);in the low dose LEV group,there was 1 case of mild somnolence,and the incidence of adverse reactions was 4.17%(1/24);in the high dose LEV group,there was 1 case of mild somnolence,1 case of excitement and grumpiness,and the incidence of adverse reactions was 8.70%(2/23).The incidence of adverse reactions in the three groups was statistically significant(P<0.05).The incidence of adverse reactions in the diazepam group was significantly higher than that in the low-dose LEV group and high-dose LEV group(P<0.05).The incidence of epilepsy in the control group,diazepam group,low-dose LEV group and high-dose LEV group were 0(0/23),0(0/22),0(0/24),4.35%(1/23),respectively.There was no significant di

关 键 词：热性惊厥 复发 地西泮 左乙拉西坦 不良反应 

分 类 号：R720.597[医药卫生—急诊医学]