左乙拉西坦致儿童不良反应文献分析  

Literature Analysis on Adverse Drug Reactions Induced by Levetiracetam in Children

作　　者：张圣洁 徐进[1] 刘瑶[1] Zhang Shengjie;Xu Jin;Liu Yao(Children’s Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院,南京210008

出　　处：《儿科药学杂志》2024年第10期25-30,共6页Journal of Pediatric Pharmacy

基　　金：江苏省药学会-奥赛康医院药学科研基金,编号A202218。

摘　　要：目的:探讨儿童使用左乙拉西坦(LEV)的安全性,分析临床药品不良反应(ADR)发生规律和特点,为临床合理应用LEV提供参考。方法:检索万方、中国知网、维普、PubMed、ScienceDirect、EMBase、Web of Science等数据库中儿童使用LEV致ADR的文献,检索时限均为建库至2023年4月30日。提取患儿临床用药信息并进行统计分析。结果:共纳入文献32篇,其中中文2篇,英文30篇。涉及39例患儿,以8~10岁(28.21%)最多,ADR多发生于用药后>3~30 d(53.85%),主要累及精神系统(27.59%)包括幻觉、自残行为、强迫症等临床表现,神经系统(24.14%)包括肌阵挛发作、头痛、局灶性癫痫等临床表现和消化系统(17.24%)包括呕吐、碱性磷酸酶水平升高、天冬氨酸氨基转移酶水平升高等临床表现。ADR发生后经对症治疗后好转。结论:LEV是一种有效的一线抗癫痫药物,尽管存在ADR发生风险,但在密切监测和个体化用药指导下,可控制风险,提高难治性癫痫的疗效。Objective:To explore the safety of levetiracetam(LEV)in children and analyze the regularity and characteristics of adverse drug reactions(ADR),so as to provide references for rational clinical use.Methods:Literature on ADR induced by LEV in children was retrieved from Wanfang,CNKI,VIP,PubMed,ScienceDirect,EMBase,Web of Science and other databases.The retrieval time was from the establishment of the databases to Apr.30th,2023.The clinical medication information of children was extracted and analyzed statistically.Results:A total of 32 literature were collected,including 2 Chinese literature and 30 English literature.Thirty-nine children were involved,most of them were aged from 8 to 10 years(28.21%).ADR of LEV mostly occurred after 3 to 30 d of medication(53.85%).ADR mainly involved the psychiatric system(27.59%),including hallucination,self-harming behaviors,obsessive-compulsive disorder and other clinical manifestations.The nervous system(24.14%)had myoclonic seizures,headache,focal epilepsy and other clinical manifestations.And the digestive system(17.24%)had vomiting,elevated alkaline phosphatase,elevated aspartate aminotransferase and other clinical manifestations.ADR was improved after symptomatic treatment.Conclusion:Despite the risks of ADR,LEV is still the effective first-line antiepileptic drug.However,under the guidance of close monitoring and individualized medication,the risks of treatment can be controlled and the curative effect of children with refractory epilepsy can be improved.

关 键 词：左乙拉西坦 儿童 不良反应 文献分析 

分 类 号：R742.1[医药卫生—神经病学与精神病学]