应用吡仑帕奈对小儿难治性癫痫添加治疗的临床研究  

Clinical study of the adjunctive treatment of perampanel in children with refractory epilepsy

作　　者：张静雯[1] 张宇昕[1] 李旭锋 梁明娟 王春 郭予雄 陈志红[1] 翟琼香[1] ZHANG Jingwen;ZHANG Yuxin;LI Xufeng;LIANG Mingjuan;WANG Chun;GUO Yuxiong;CHEN Zhihong;ZHAI Qiongxiang(Guangdong General Hospital(Guangdong Academy of Medical Sciences),Department of Pediatrics,Guangzhou 510080,China;Guangdong General Hospital(Guangdong Academy of Medical Sciences),Pediatric Intensive Care Unit,Guangzhou 510080,China)

机构地区：[1]广东省人民医院(广东省医学科学院)儿科,广州510080 [2]广东省人民医院(广东省医学科学院)儿科重症监护室,广州510080

出　　处：《癫痫杂志》2022年第3期232-235,共4页Journal of Epilepsy

基　　金：国家重点研发计划项目(2016YFC306200);国家自然科学青年基金(81701284);广东省科技计划项目(2017A020215052);广州市科技计划项目(202002030428)。

摘　　要：目的 研究吡仑帕奈添加治疗难治性癫痫患儿的疗效及不良反应。方法 前瞻性对2020年1月—2021年2月在广东省人民医院小儿癫痫专科诊治的45例难治性癫痫患儿使用吡仑帕奈添加治疗自身对照研究,制定入组标准及吡仑帕奈起始剂量。每月随诊一次,3个月检查异常血常规、肝功能、肾功能、体液免疫,6个月复查一次脑电图。剂量为0.04 mg/(kg·d)(最大起始量不超过2 mg/d),每两周增加0.04 mg/(kg·d)(最大维持量不超过6 mg/d)。观察吡仑帕奈的疗效及不良反应。对比吡仑帕奈添加前和添加6个月后的24 h视频脑电图及临床发作。结果 45例患儿中经添加治疗后临床发作完全控制7例、发作减少26例,总有效率73.33%。添加吡仑帕奈治疗后28例患儿脑电图的癫痫样放电减少,有效率为62.22%。观察期血常规、肝功能、肾功能、体液免疫,均在正常范围。添加吡仑帕奈治疗后共有10例出现不良反应,不良反应率为22.22%。结论 吡仑帕奈添加治疗难治性癫痫能具有良好的有效性和安全性。Objective To study the efficacy and adverse events of adjunctive perampanel in children with refractory epilepsy.Methods A prospective study was carried out in 45 children with refractory epilepsy,who were treated in our hospital from January 2020 to February 2021 using perampanel as an add-on treatment,with a criteria for enrollment and the starting dose of perampanel.Follow-up would be taken at once a month.Afte 3 months would check blood routine,liver function,kidney function and humoral immunity.The EEG was reviewed after 6 months.The initial dose of perampanel was 0.04 mg/(kg·d)(the maximum didn’t exceed 2 mg/d),increasing by 0.04 mg/(kg·d) every two weeks,and the maximum maintenance dose didn’t exceed 6 mg/d.The efficacy and adverse reactions of perampanel were evaluated by comparing the seizure frequency and EEG results before and after a 6-month add-on therapy.Results Among the 45 children,complete seizure control was achieved in 7 cases after the therapy,and the seizure attacks were reduced in 26 cases,showing a total response rate of 73.3%.After the treatment,the epileptiform discharge of 28 children was reduced,and the effective rate was 62.22%.During the observation period,all the blood routine,liver function,kidney function,and humoral immunity of the children were normal.10 cases of adverse reactions occurred after the additional treatment of perampanel,and the adverse reaction rate was 22.22%.Conclusions Perampanel has good efficacy and safety in the add-on treatment of refractory epilepsy.

关 键 词：吡仑帕奈 难治性癫痫 疗效 不良反应 

分 类 号：R742.1[医药卫生—神经病学与精神病学]