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目的评估2岁以下癫痫婴幼儿应用左乙拉西坦(LEV)的疗效及安全性,为临床有效防治提供参考依据。方法对2010年1月-2011年12月西安交通大学第二附属医院儿科神经专科住院确诊的2岁以下癫痫患儿中,服用LEV的39例患儿进行临床分析,收集患儿发作类型、家族史、影像学等资料,并进行为期6~72个月的随访,评估患儿治疗情况、疗效及不良反应等。结果左乙拉西坦单药治疗终量有82.7%的患儿为中低剂量,添加治疗剂量组70%的患儿为高剂量。左乙拉西坦治疗2岁以下癫痫患儿,6个月总有效率为82.1%,完全控制率为61.5%。其中,对于局灶性发作、强直阵挛发作有效率分别为76%和55.6%,对于失张力及肌阵挛发作效果差。单药及添加治疗的不良反应发生率均较低,提示左乙拉西坦具有较高安全性。结论左乙拉西坦是一种广谱有效的抗癫痫药物,作为单药治疗或添加治疗对部分或全面性发作均具有良好疗效,具有较高的耐受性及保留率,是2岁内儿童癫痫一种有益的选择。
Objective To evaluate the efficacy and safety of levodisetine (LEV) in infants under 2 years of age, and provide reference for effective clinical prevention and treatment. Methods From January 2010 to December 2011, 39 children with LEV undergoing hospitalization for pediatric neurosurgery in the Second Affiliated Hospital of Xi’an Jiaotong University were enrolled in this study. The clinical data of 39 children with LEV were collected, History, imaging and other information, and for a period of 6 to 72 months follow-up, evaluation of children with treatment, efficacy and adverse reactions. Results The final dose of levetiracetam monotherapy was 82.7% of children with low dose, and 70% of children with high dose of therapeutic dose group. Levetiracetam in children under 2 years of age with epilepsy, six months, the total effective rate was 82.1%, the complete control rate was 61.5%. Among them, the focal seizures, tonic clonic seizures were 76% and 55.6%, respectively, for the loss of tension and myoclonus seizures poor results. The incidence of adverse reactions of monotherapy and adjuvant therapy were low, suggesting that levetiracetam has higher safety. Conclusion Levetiracetam is a broad-spectrum effective anti-epileptic drug. As a monotherapy or adjunctive therapy, levetiracetam has good efficacy on partial or complete seizures, high tolerability and retention, and is within 2 years of age A good choice for children with epilepsy.