拉莫三嗪单药治疗新诊断儿童癫的疗效

Curative Effect of Lamotrigine Monotherapy for Original Diagnosed Epilepsy in Children

目的观察拉莫三嗪(LTG)单药治疗新诊断儿童癫的疗效和安全性。方法选取2008年1月-2009年12月本院儿科神经门诊31例新诊断癫、使用LTG单药治疗的患儿。年龄6～16岁。将其中28例资料完整的患儿进行开放性自身对照研究。其中局限性发作24例(简单局限性发作18例,复杂局限性发作4例,局限继发全面性发作2例),全面强直-阵挛性发作4例。本组患儿均为首次诊断癫患儿,在此之前均未使用过任何抗癫药物;且患儿均为隐源性(或原发性)癫,经头颅CT或MRI、血生化、血常规等检查未发现其他系统疾病。LTG初始剂量为0.5 mg.kg-1.d-1,每周加量1次(0.5 mg.kg-1),4周增加至目标剂量4.0～5.0 mg.kg-1.d-1,平均剂量3.5 mg.kg-1.d-1。结果 31例患儿中3例失访,失访率9.68%。28例患儿随访时间均在6个月以上。总有效率为89.28%(25/28例),其中20例症状完全控制(71.43%,20/28例)。5例发作频率减少≥50%(17.86%,5/28例),2例症状控制不满意而加用第2种抗癫药物,1例(3.57%)因皮疹自行停药。不良反应为乏力(3/28例)、嗜睡(2/28例)、皮疹(1/28例);除1例出现皮疹停药外,其余患儿均未特殊处理,症状自然消失。结论 LTG单药治疗新诊断儿童癫疗效及安全性好,是单药治疗儿童新诊断癫的有效药物。

Objective To observe of curative effect and safety of lamotrigine（LTG） monotherapy for original diagnosed epilepsy in children.Methods Thirty-one children with original diagnosed epilepsy were treated with LTG monotherapy（age ranged from 6 to 16 years）,and 28 children with complete data were investigated by a self-controlled and open-research.Twenty-four children were partial seizure（18 children were simple partial seizure,and 4 children were complex partial seizure,2 children were partial secondary general seizure）,4 children were tonic-clonic seizure.All of children were original diagnosed epilepsy,and did′t used any drug,and skulls CT and MRI、blood routine and blood biochemistry were normal.LTG was used originally at a dose of 0.5 mg·kg^-1·d^-1（after increase one time at 1 week;0.5 mg·kg^-1）,4 weeks achieved the goal dosage（4.0-5.0 mg·kg^-1·d^-1,with a mean dose of 3.5 mg·kg^-1·d^-1）.Results Three children were disurvey.Twenty-eight children with original diagnosed epilepsy were followed up for more than 6 months.Total effective rate was 89.28%（25/28 cases）,and 20 children（71.43%） had seizure-free,and 5 children（17.86%） had at least 50% reduction seizures,and 2 children（7.14%） of LTG therapy was discontinued and added other drug,and 1 child（3.57%） stopped drug induced to skin rashes.LTG therapy-related adverse included asthenia（3/28 cases）,somnolence（2/28 cases）,skin rashes（1/28 cases）.The adverse effects were spontaneously disappeared without any deal with（except 1 child stopped drug with skin rashes）.Conclusion LTG monotherapy is effective and safe for the control of seizures in children of original diagnosed epilepsy.