摘要
目的探讨托吡酯单一或联合治疗Lennox-Gastaut综合征(LGS)的疗效及不良反应.方法选择符合LGS诊断标准、并经规范治疗未能控制发作者24例,小剂量逐渐添加托吡酯,直至出现疗效或不能耐受的不良反应.观察疗程平均9个月.结果除2例因不良反应和发作增加退出治疗,余22例观察疗程均在6～15个月,总有效率82.6%.发作消失45.8%,其中强直痉挛发作减少50%以上者占82.2%,完全控制66.7%;肌阵挛减少50%以上占81.8%,完全控制58.8%;不典型失神发作减少50%以上占81.8%,完全控制63.6%.最大疗效出现时间2～40周,此时剂量2～10mg/(kg·d).不良反应中食欲减退8例,语言障碍5例,嗜睡4例,记忆力下降、体质量下降或不增、注意力不集中、抑郁各3例,精神运动迟缓2例,皮损、木僵、肉眼血尿各1例.使用期间监测肝肾功能均为正常.结论托吡酯是一种广谱、有效、安全的新型抗癫(癎)药物,治疗LGS有明显疗效.
Objective To explore the effect and adverse reaction of topiramate（TPM） on treating Lermox-Gastaut syndrome （LGS） （including therapeutic alliance or single ）. Methods Twenty-four cases with LGS whose attacks could not be controlled by regular therapy were selected. TPM was gradually increased from low dosage till its showing effect or untolerant adverse reaction. Results Two cases were excluded because of adverse reaction and increase of attacks. The remained cases were followed up from 6 months to 15 months （average： 9 months）. The total effective rate was 82.6%, 11 cases accounting for 45.8% free of attack. The tonic-clonic seizure reduced more than 50% accounting for 82.2%, the full control accounting for 66.7%. The myoclonic seizure reduced more than 50% accounting for 81.8%, the full control accounting for 58.8%. The atypical absence seizure reduced more than 50% accounting for 81.8%, the full control accounting for 63.6%. The maximum effect occurred about 2-40 weeks following TPM used, the dosage about 2- 10 mg/（kg·d）. The adverse reaction included anorexia （8 cases）, language disorder （5 cases）, drowsiness （4 cases）, decrease of anamnesis （3 cases）, weight toss or unchanged（3 cases）, inattention （3 cases）, depression （3 cases）, mental bradypraxia （2 cases ）,skin damage （ 1 case）, stupor （ 1 case）, gross hematuria（ 1 case）. The hepatic and renal function were normal during therapy. Conclusion TPM is a new, broad-spectrum, effective and safe antiepileptics drug on treating LGS.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2005年第8期797-799,共3页
Journal of Applied Clinical Pediatrics
