左乙拉西坦治疗癫痫的疗效及安全性的随访分析

Efficacy and safety of Levetiracetam in epilepsy:a following-up analysis

目的观察左乙拉西坦(LEV商品名"Keppra")单药或添加治疗儿童及成人各类型癫痫的临床疗效及安全性。方法采用开放性自身对照的研究方法,以四川大学华西医院神经内科自2008年2月～2009年6月收治的80例门诊和住院癫痫患者为研究对象,对其进行6个月的LEV治疗并随访,观察LEV对癫痫患者的疗效及不良反应。结果80例随访观察对象接受LEV治疗≥6个月后,达到完全控制的为15例,占18.8%;LEV治疗有效的35例,占43.7%;而有30例患者对LEV治疗无效,占37.5%,即总应答率为62.5%。总体上LEV添加或单药治疗各种类型癫痫临床效果肯定,患者年龄、病程、是否有头部影像学异常对其疗效影响不大,单药治疗或添加治疗癫痫的临床疗效亦无统计学差异,而与癫痫的类型相关,LEV对复杂部分性发作继发全面性发作疗效最好(应答率79.5%)。随访过程中失访6例(7.8%),出现不良反应9例(11.3%)。结论LEV作为一种新型抗癫痫药物,单药治疗或添加治疗成人及儿童各种类型癫痫具有较好的疗效和安全性。

Objective To analysis the efficacy and safety of Levetiracetam（LEV）in Epilepsy.Methods The method of self-control study was used.Since February 2008 to June 2009,80 cases of outpatients and inpatients from West China Hospital of Sichuan University,Department of Neurology with epilepsy were eligible.The LEV treatment lasted for at least 6 months,and the efficacy and side effects were assessed.Results 80 patients receiving the treatment of LEV at least 6 months,compared with their baseline seizure frequency.15 cases（18.8%）achieved seizure free,and 35（43.7%）had their seizure frequency decrease by ≥50% but not seizure free.The responder rate was 62.5%.There was no difference in efficacy between children and adult patients,different courses,idiopathic epilepsy and symptomatic epilepsy,and also in monotherapy and adjunctive therapy.But there was significant difference between different epilepsy types,and complex partial seizures followed by generalized tonic-clonic seizure showed the best efficacy.9 patients（11.3%）had slight adverse reactions.Conclusion LEV as a novel AED,has well efficacy for epilepsy patients,and seems to be well tolerated with very few reported side effects.