左乙拉西坦治疗新生儿难治性惊厥的临床疗效及影响预后的相关因素  

Clinical Efficacy of Levetiracetam in the Treatment of Neonatal Refractory Convulsions and Influencing Factors of Prognosis

作　　者：苏丽娜 李文琳 陈彩华 杜积昌 Su Lina;Li Wenlin;Chen Caihua;Du Jichang(Hainan Women and Children’s Medical Center,Hainan Haikou 570100,China;Hainan Modern Hospital for Women and Children,Hainan Haikou 571100,China)

机构地区：[1]海南省妇女儿童医学中心,海南海口570100 [2]海南现代妇女儿童医院,海南海口571100

出　　处：《儿科药学杂志》2021年第4期16-19,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨左乙拉西坦治疗新生儿难治性惊厥的临床疗效及影响预后的相关因素。方法:选取2016年4月至2018年3月海南省妇女儿童医学中心收治的惊厥新生儿80例,分析左乙拉西坦治疗新生儿难治性惊厥的临床疗效,将治疗有效患儿纳入预后良好组(n=62),治疗无效患儿纳入预后不良组(n=18),通过Logistic多元回归分析新生儿难治性惊厥预后的相关因素。结果:随访至1岁,80例患儿中治疗无效18例,有效3例,显效10例,完全控制49例,总有效率77.5%。随访过程中未发生不良反应。预后良好组及预后不良组患儿惊厥发作持续时间≥15 min、脑电图重度异常、脑结构发育异常、先天性代谢性疾病、惊厥家族史及惊厥每日发作频率比较差异有统计学意义(P<0.05)。Logistic多元回归分析显示,脑结构发育异常及惊厥每日发作均为影响新生儿难治性惊厥预后的独立危险因素(P<0.05)。结论:左乙拉西坦治疗新生儿难治性惊厥具有较高的安全性。脑电图重度异常及惊厥每日发作均为影响新生儿难治性惊厥预后的独立危险因素,脑电图可作为临床判断惊厥预后情况的参考指标。Objective:To probe into the clinical efficacy of levetiracetam in the treatment of neonatal refractory convulsions and influencing factors of prognosis.Methods:Totally 80 neonates with convulsions admitted into Hainan Women and Children’s Medical Center from Apr.2016 to Mar.2018 were extracted.The clinical efficacy of levetiracetam in the treatment of neonatal refractory convulsions was analyzed.The children with effective treatment were enrolled in the good prognosis group(n=62),while the children with ineffective treatment were included in the poor prognosis group(n=18).Logistic multiple regression was used to analyze the influencing factors of prognosis of neonatal refractory convulsions.Results:Eighty children were followed up to one year old,of which 18 cases were ineffective,3 cases were effective,10 cases were markedly effective,49 cases were completely controlled,and the total effective rate was 77.5%.No adverse drug reactions occurred during the follow-up.There were statistically significant differences between the good prognosis group and the poor prognosis group in the duration of convulsions≥15 min,severe abnormalities in EEG,abnormal brain structure development,congenital metabolic diseases,family history of convulsions and daily seizures(P<0.05).Logistic multiple regression analysis showed that abnormal brain structure and daily seizures were independent risk factors for the prognosis of neonatal refractory convulsions(P<0.05).Conclusion:Levetiracetam has higher safety in the treatment of neonatal refractory convulsions.Severe abnormalities in EEG and daily seizures are independent risk factors that affect neonatal refractory convulsions.EEG can be used as a reference indicator for clinical diagnosis of prognosis.

关 键 词：左乙拉西坦 难治性惊厥 新生儿 预后因素 LOGISTIC多元回归分析 

分 类 号：R722.1[医药卫生—儿科]