拉莫三嗪早期联合硝基安定治疗儿童失神癫痫的临床效果  

Clinical effect of early add⁃on nitrodiazepam to lamotrigine on absence epilepsy in children

作　　者：林海生 戴津 程冰梅 江慧敏 肖华 王秀英 李嘉玲 陈文雄 LIN Haisheng;DAI Jin;CHENG Bingmei;JIANG Huimin;XIAO Hua;WANG Xiuying;LI Jialing;CHEN Wenxiong(Department of Neurology,Guangzhou Women and Children′s Medical Center,Guangzhou 510120,China)

机构地区：[1]广州市妇女儿童医疗中心神经内科,广州510120

出　　处：《实用医学杂志》2021年第24期3193-3196,共4页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金项目(编号:B2019030)。

摘　　要：目的对比观察拉莫三嗪(LTG)早期联合硝基安定(NZP)与丙戊酸钠(VPA)单药治疗儿童失神癫痫的疗效及不良反应。方法选取通过典型临床表现和视频脑电图确诊儿童失神癫痫患儿52例,将其分为VPA组26例及LTG+NZP组26例,分别给予丙戊酸钠单药或拉莫三嗪早期联合硝基安定(服用第4个月开始1个月内逐渐减停)治疗,随访1年,观察患者的发作控制情况以及不良反应。结果VPA组和LTG+NZP组患儿服药1个月时完全控制的分别为12例(48.0%)、10例(41.7%);3个月时分别为14例(56.0%)和12例(50.0%);6个月时分别15例(60.0%)和14例(58.3%);12个月时分别为17例(68.0%)和16例(66.7%),差异均无统计学意义(P>0.05)。VPA组和LTG+NZP组患儿治疗后1个月的总有效率分别为68.0%和66.7%;治疗后3个月总有效率分别为72.0%和66.7%;治疗后6个月总有效率分别为76.0%和75.0%;治疗后12个月分别为84.0%和79.2%,差异无统计学意义(P>0.05)。两组患儿不良反应发生率差异无统计学意义(P>0.05)。结论拉莫三嗪早期联合硝基安定治疗儿童失神癫痫疗效与丙戊酸钠相当;拉莫三嗪早期短时联合添加硝基安定治疗儿童失神癫痫,能兼顾疗效和起效速度。Objective To compare the efficacy and side effects between early add⁃on Nitrodiazepam(NZP)to Lamotrigine(LTG)and sodium valproate(VPA)only on absence epilepsy in children.Methods The children with epilepsy diagnosed by typical clinical manifestations and video electroencephalogram were divided into VPA group(n=26)and LTG+NZP group(n=26).The children were treated with VPA or early add⁃on NZP to LTG respectively(NZP tailed off at 4th month within one month).The patients were followed up for 1 year to observe seizure control and adverse reactions of the patients.Results In VPA group and LTG+NZP group,12 cases(48.0%)and 10 cases(41.7%)were completely controlled at the first month;14 cases(56.0%)and 12 cases(50.0%)at the 3rd month;15 cases(60.0%)and 14 cases(58.3%),at the 6th month;and 17 cases(68.0%)and 16 cases(66.7%),at 12 months,indicating no statistical significance(P>0.05).The total effective rate of VPA group and LTG+NZP group was 68.0%and 66.7%1 month after treatment,72.0%and 66.7%3 months after treatment,76.0%and 75.0%6 months after treatment,and 84.0%and 79.2%12 months after treatment,respec⁃tively,showing no significant difference(P>0.05).There was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05).Conclusion Early add⁃on NZP to LTG onchildren with absence epilepsy has nearly the same efficacy as sodium valproate.Early add⁃on NZP to LTG on children with absence epilepsy might take both curative effect and onset time into consideration.

关 键 词：拉莫三嗪 硝基安定 丙戊酸钠 失神癫痫 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]