摘要
目的比较5种抗癫痫药(AEDs)单药治疗初诊儿童癫痫患者的2 a单药保留率,为儿童癫痫患者的药物选择提供参考。方法采用前瞻性登记队列研究方法,选择2002年1月至2012年1月初诊儿童癫痫患者564例,根据患儿首次选用AEDs名称将患儿分为5组,即卡马西平(CBZ)组、丙戊酸(VPA)组、托吡酯(TPM)组、奥卡西平(OXC)组和拉莫三嗪(LTG)组,通过门诊随访患者的停药时间及停药原因,比较其6、12和24个月的单药保留率。结果6个月单药保留率OXC组患儿为82.98%,LTG组患儿为79.69%,TPM组患儿为68.49%,CBZ组患儿为51.15%,VPA组患儿为46.18%;12个月单药保留率LTG组患儿为76.56%,OXC组患儿为74.47%,TPM组患儿为61.64%,CBZ组患儿为42.75%,VPA组患儿为42.17%;24个月单药保留率LTG组患儿为71.88%,OXC组患儿为61.70%,TPM组患儿为60.27%,CBZ组患儿为41.22%,VPA组患儿为40.56%。6、12、24个月单药保留率LTG组、OXC组、TPM组患儿均明显高于CBZ组和VPA组(P<0.05),但LTG组、OXC组、TPM组患儿之间单药保留率比较差异无统计学意义(P>0.05)。停药原因上,因依从性差停药患儿占40.79%,因疗效不佳停药患儿占38.63%,这是导致患儿停药的2个主要原因。结论 LTG、OXC和TPM比较适合作为儿童癫痫治疗的首选药物,导致患儿停药的主要原因是药物疗效不佳和依从性差。
Objective To compare the 2 years single drug retention rates of five types of antiepileptic drugs（ AEDs） in first diagnosed epileptic children and to provide reference for the drug selection of epileptic children. Methods This study adopted prospective registration cohort study method. Five hundred and sixty-four children were recruited who were first diagnosed with epilepsy from January 2002 to January 2012. These children were divided into carbamazepine（ CBZ） group,oxcarbazepine（ OXC） group,lamotrigine（ LTG） group,topiramate（ TPM） group and yalproic acid（ VPA） group according to the name of AEDs. The time and reasons of drug withdrawal were obtained by outpatient follow-up and the single drug retention rates in 6,12,24 months were compared. Results After six months,the single drug retention rate of patients in OXC group,LTG group,TPM group,CBZ group and VPA group was 82. 98%,79. 69%,68. 49%,51. 15% and 46. 18%,respectively. After 12 months,the single drug retention rate of patients in LTG group,OXC group,TPM group,CBZ group and VPA group was76. 56%,74. 47%,61. 64%,42. 75% and 42. 17%,respectively. After 24 months,the single drug retention rate of patients in LTG group,OXC group,TPM group,CBZ group and VPA group was 71. 88%,61. 70%,60. 27%,41. 22% and 40. 56%,respectively. The single drug retention rates of patients in LTG group,OXC group and TPM group were significantly higher than those in CBZ group and VPA group（ P〈0. 05） in 6,12,24 months; but no significant differences were found among LTG group,OXC group and TPM group（ P〈0. 05）. The main reasons for drug withdrawal were poor compliance（ 40. 79%） and poor efficacy（ 38. 63%）. Conclusion LTG,OXC and TPM are the first choices for epileptic children; the main reasons for drug withdrawal in children are poor efficacy and poor compliance.
出处
《新乡医学院学报》
CAS
2016年第4期297-301,共5页
Journal of Xinxiang Medical University
基金
河南省医学科技攻关计划资助项目(编号:201403136)
关键词
抗癫痫药
癫痫
儿童
单药保留率
antiepileptic drugs
epileptic
child
single drug retention rate
