新一代抗癫痫药物对成人全面强直阵挛发作单药治疗保留率的比较

The Retention Rate of New Antiepileptic Drugs in Treating Adults with Generalized Tonic-clonic Seizure

目的比较5种新一代抗癫痫药物对成人全面强直阵挛发作单药治疗的保留率。方法选择2010年7月-2011年6月354例确诊为癫痫全面强直阵挛发作患者,分别采用拉莫三嗪、左乙拉西坦、奥卡西平、托吡酯、加巴喷丁5种药物进行单药治疗,对其5种药物的6、12个月保留率进行比较。结果 5种药物的6、12个月保留率分别为:拉莫三嗪90.8%、79.8%,左乙拉西坦88.0%、66.7%,奥卡西平82.1%、58.2%,托吡酯81.2%、58.0%,加巴喷丁26.5%、20.6%。6个月保留率加巴喷丁与其他4种药物比较差异有统计学意义(P<0.001),其他药物之间差异无统计学意义。12个月保留率拉莫三嗪与其他4种药物比较差异有统计学意义(P<0.005),其他药物之间差异无统计学意义。结论拉莫三嗪对成人全面强直阵挛发作单药治疗12个月保留率最高。通过对5种新一代抗癫痫药物12个月保留率比较研究,可以对临床单药治疗癫痫药物选择提供一定参考。

Objective To compare the retention rate of five new antiepileptic drugs （AEDs） in treating adults with generalized tonic-clonic seizure. Methods A total of 354 patients diagnosed with generalized tonic-clonic seizure were treated with five AEDs separately, including lamotrigine （LTG）, levetiracetam （LEV）, oxcabazepine （OXC）, topiramate （TPM）, and gabapentin （GAB）. The 6- and 12-month retention rates of these five drug treatments were compared. Results The 6- and 12-month retention rates were respectively LTG （90.8%, 79.8%）, LEV （88.0%, 66.7%）, OXC （82.1%, 58.2%）, TPM （81.2%, 58.0%） and GAB （26.5%, 20.6%）. For 6-month retention rate, the lowest was GAB, which was significantly different from others （P 〈 0.001）; no difference was found among the other AEDs. For 12-month retention rate, the highest was LTG, which was significantly different from others （P 〈 0.005）; no difference was found among the other AEDs. Conclusions LTG has the highest one-year retention rate in treating adults with generalized tonic-clonic seizure. The comparison of retention rates among the new AEDs can provide useful insight for the choice of antiepileptic drugs for adults with generalized tonic-clonic seizure.