拉莫三嗪与奥卡西平初始单药治疗新诊断BECT药物保留率及疗效研究  

Study on retention rate and efficacy of lamotrigine and oxcarbazepine in treatment of newly diagnozed benign childhood epilepsy with centro-temporal spikes

作　　者：赵斯钰[1] 吴岩 梁丽丽 宋西晓[1] 汪东[1] 王燕[1] ZHAO Siyu;WU Yan;LIANG Lili;SONG Xixiao;WANG Dong;WANG Yan(Department of Pediatric Internal Neurology,Xi'an Municipal Children's Hospital,Shaanxi Xi'an 710003,China)

机构地区：[1]西安市儿童医院神经内科,陕西西安710003

出　　处：《中国妇幼健康研究》2021年第12期1782-1787,共6页Chinese Journal of Woman and Child Health Research

基　　金：陕西省社会发展科技攻关项目(2015SF214);西安市科技局项目(J201903061)。

摘　　要：目的比较拉莫三嗪(LTG)与奥卡西平(OXC)作为初始单药治疗新诊断儿童良性癫痫伴中央颞区棘波(BECT)的药物保留率和疗效研究。方法收集初始LTG或OXC单药治疗的新诊断BECT患儿的临床资料,随访至停药或至少随访1年,评价两种药物1年的总药物保留率、单药保留率及疗效,探寻影响药物保留率的相关危险因素。结果共有240例新诊断BECT患儿纳入本次研究,至随访终点时,LTG组和OXC组1年总药物保留率分别为90.3%和80.2%,LTG组1年总药物保留率高于OXC组,差异有统计学意义(Log-Rank test χ^(2)=3.910,P<0.05);LTG组和OXC组1年单药保留率分别为80.6%和67.3%,LTG组1年单药保留率高于OXC组,差异有统计学意义(Log-Rank test χ^(2)=4.546,P<0.05);LTG组与OXC组无发作率分别为85.3%和82.4%,差异无统计学意义(χ^(2)=1.892,P>0.05)。BECT分型是BECT总药物保留率、单药保留率的影响因素(HR=2.61,95%CI=1.24~5.51,P<0.05;HR=4.32,95%CI=2.55~7.32,P<0.05)。结论LTG作为初始单药治疗BECT,疗效与OXC相似,但在1年单药保留率和总药物保留率方面,LTG高于OXC,具有较好的耐受性,可作为新诊断的BECT儿童的初始单药治疗选择。Objective To compare retention rate and efficacy of lamotrigine(LTG)and oxcarbazepine(OXC)as initial monotherapy in treatment of childhood benign epilepsy with centro-temporal spikes(BECT).Methods The clinical data of 240 patients with newly diagnozed BECT who were initially treated with LTG or OXC were collected and the patients were followed up till to drug withdrawal or at least 1 year.The 1-year overall drug retention rate,single drug retention rate and efficacy of the two drugs of the patients were evaluated,and the risk factors affecting drug retention rate were explored.Results A total of 240 patients with newly diagnozed BECT were enrolled in this study.At end of follow-up,the 1-year overall drug retention rate in LTG group and OXC group was 90.3% and 80.2% respectively,showing that the 1-year overall drug retention rate in LTG group was significantly higher than that in OXC group(Log-Rank test χ^(2)=3.910,P<0.05).The 1-year single-drug retention rate of LTG group and OXC group was 80.6% and 67.3% respectively,showing that the 1-year single-drug retention rate in LTG group was significantly higher than that in OXC group(Log-Rank testχ^(2)=4.546,P<0.05).The seizure-freedom rate in LTG group and OXC group was 85.3% and 82.4% respectively,and the difference was not statistically significant(χ^(2)=1.892,P>0.05).The clinical typing of BECT was a factor affecting the overall drug retention rate and single-drug retention rate in the patients with BECT(HR=2.61,95%CI=1.24-5.51,P<0.05;HR=4.32,95%CI=2.55-7.32,P<0.05).Conclusion The efficacy of LTG as an initial single drug in treatment of BECT is similar to that of OXC,but in terms of 1-year single drug retention rate and 1-year overall drug retention rate,LTG has better tolerance than OXC,and can be used as the initial monotherapy for children with newly diagnozed BECT.

关 键 词：拉莫三嗪 奥卡西平 BECT 药物保留率 疗效 

分 类 号：R729[医药卫生—儿科]