不同撤药速度对癫痫患者复发的影响

Influence of normal versus slow antiepileptic drugs withdrawal on seizure recurrence in patients with epilepsy

目的探讨不同撤药速度对癫痫患者复发的影响。方法前瞻性收集达≥2年无发作癫痫患者的临床资料,根据撤药速度分为正常(撤药期6个月左右)和缓慢组(撤药期>6个月)。随访至癫痫复发或至少随访2年。结果共收集76例撤药癫痫患者(正常组47例,缓慢组29例),平均随访(2.0±1.5)年。随访终点累计复发率为53.9%;两组患者撤药后3、6、12、24个月癫痫复发率分别为12.8%vs.6.9%(P=0.41)、29.8%vs.13.8%(P=0.11)、42.6%vs.41.4%(P=0.92)、50.0%vs.55.2%(P=0.66),差异均无统计学意义。Kaplan-Meier生存分析法显示,两组患者撤药至复发时间差异也无统计学意义(Log-Rank test掊2=0.019,P=0.889)。结论对达≥2年无发作癫痫患者,与6个月撤药相比,撤药时间大于6个月对复发无明显影响。

Objective To explore the influence of normal and slow antiepileptic drugs （AEDs） withdrawal on recurrence of epilepsy. Methods Epileptic patients with seizure-free more than 2 years were recruited to the study. They were first divided into normal （taper period of six months or less） and slow AEDs withdrawal groups （taper pe- riod of more than six months） and then followed up prospectively for more than 2 years. Kaplan-Meier survive statis- tics was used to analyze the time interval between medication withdrawal and seizure relapse. Results Seventy-six epileptic patients were recruited to the study prospectively （47 in normal group and 29 in slow group ）. The patients were followed up for 2.0 ± 1.5 years. The recurrence rate for 76 patients was 53.9%. The recurrence rates in normal group vs slow group were 12.8% vs. 6.9% （P = 0.41）, 29.8% vs. 13.8% （P = 0.11）, 42.6% vs. 41.4% （P = 0.92）, 50.0% vs. 55.2% （P = 0.66） at 3, 6, 12 and 24 months following AEDs withdrawal. There was no statisti- cally difference in recurrence interval between normal and late withdrawal groups （P = 0.889）. Conclusions The seizure recurrence rate in epileptic patients with seizure-free for ≥ 2 years is not different between normal drug with- drawal （six month） and slow drug withdrawal （great than six month）.