论文部分内容阅读
目的前瞻性比较丙戊酸钠(VPA)和左乙拉西坦(LEV)在儿童良性癫痫伴中央颞区棘波(BECT)治疗中的有效性和副作用情况,从而探讨LEV治疗BECT的可行性。方法选择在我院癫痫中心2008年2月至2009年12月诊断并治疗的26例BECT患者,利用奇偶数分为LEV组和VPA组,分别进行药物治疗,在治疗后15个月对疗效和副反应进行随访。结果本组病例男15例,女11例,平均病程1.38年,总智商(FIQ)≥90分21例,平均102.23分。治疗后4～15个月发作停止者15例,其中LEV组8例,VPA组为7例;治疗无效者每组各2例。发作次数为LEV组由55次减少为13次,VPA组由62次减少为18次。觉醒期脑电图恢复正常者LEV组2例,VPA组3例;脑电图棘波较治疗前减少超过50%者两组各为LEV组9例,VPA组6例。两组癫痫和痫性放电控制无统计学差异。LEV组较治疗前FIQ增加3.92分,VPA组增加1.69分,两组智商变化值有统计学差异。LEV组有一过性副反应4例,VPA组有一过性副反应2例,持久性副反应6例,在持久性药物相关副反应方面两组有统计学差异。结论 LEV治疗BECT时在癫痫和棘波的控制方面与VPA水平相当,但长期副反应罕见,所以应当优先选择应用。
Objective To prospectively compare the efficacy and side effects of VPA and LEV in the treatment of benign epilepsy with centrotemporal spikes (BECT) in children and to explore the feasibility of LEV in the treatment of BECT . Methods Twenty-six patients with BECT diagnosed and treated in epilepsy center from February 2008 to December 2009 in our hospital were divided into two groups: LEV group and VPA group, Side effects were followed up. Results The group of 15 males and 11 females, average duration of 1.38 years, total intelligence (FIQ) ≥ 90 points in 21 cases, an average of 102.23 points. 15 cases were stopped in 4 to 15 months after treatment, including 8 cases in LEV group and 7 cases in VPA group; 2 cases in each group were ineffective. The number of episodes was reduced from 55 to 13 in the LEV group and from 62 to 18 in the VPA group. There were 2 cases of LEV group and 3 cases of VPA group. The amplitude of electroencephalogram spikes was reduced by more than 50% compared with that before treatment. There were 9 cases in LEV group and 6 cases in VPA group. Two groups of epilepsy and epileptic discharge control no significant difference. LEV group than before treatment FIQ increased 3.92 points, VPA group increased 1.69 points, two sets of IQ changes were statistically significant. LEV group had transient side effects in 4 cases, VPA group had transient adverse reactions in 2 cases, 6 cases of persistent adverse reactions, persistent drug-related side effects in the two groups were statistically different. Conclusions LEV is equivalent to VPA in the control of epilepsy and spikes when treating BECT, but long-term side effects are rare and should be given priority.