左乙拉西坦治疗老年女性部分性发作癫痫患者的临床观察

Efficacy Observation Treatment of Partial of Levetiracetam in the Seizures in the Elderly

目的：探讨左乙拉西坦（LEV）单药及添加药物治疗老年女性部分性发作（PS）或继发全面性发作（SGTCS）癫痫患者的有效率及不良反应。方法：采用自身对照方法，应用LEV对59例PS和SGTCS的老年女性癫痫患者进行单药及添加药物治疗，目标维持剂量为1000～2000mtg／d，分2次给药。观察LEV的有效率及不良反应，并分别分析LEV在仅患癫痫患者和合并其它疾病的癫痫患者以及单药和添加药物治疗患者之间有效率的差别和意义。结果：服用LEV后在第3、6、9和12个月末时的有效率分别为76．2％、70．6％、64．3％和66．7％，不同观察点的l临床疗效差异无统计学意义（Х^2=1．911，P=0．591）。在合并其它基础疾病用药的癫痫病例中LEV仍显示良好的疗效，LEV对不同癫痫发作类型的临床疗效比较差异无统计学意义（6个月末Х=1．315，P〉0．05，12个月末Х^2=2．7，P〉0．05）。在控制无发作比例上在6个月末和12个月末单药治疗明显比添加药物治疗高（Х^2=10．83，P〈0．05）。总不良反应发生率为13．6％，主要为恶心、乏力、嗜睡、头疼、食欲不振、记忆力减退和易激惹。结论：LEV单药及添加药物治疗PS、SGTCS癫痫疗效确切，特别在合并非抗癫痫用药的患者中，临床疗效同样持续、稳定。

OBJECTIVE： To analyse the effective rate and adverse effect of only levetiracetam （LEV） versus LEV plus other drugs in the treatment of old aged patients with partial seizures （ PS ） and secondary generalized tonic - clonic seizure （SGTCS）. METHODS： The self- control study was used and 59 elderly patients with PS and SGTCS were treated by LEV single or plus drug （1000- 2000mg/d, bid）. The effective rate and the side effects of LEV were observed and compared between LEV single and plus drug. The patients were only epilepsy or epilepsy plus other diseases respectively. RESULTS ： The effective rate at the end of 3, 6, 9 and 12 months after LEV treatment was 76. 2% , 70. 6% , 64. 3% and 66. 7% respectively. There was no significant difference （ Х^2 = 1. 911 ,P 〉 0. 05 ）. A chi- square test showed that in effective rate there were not statistically significant differences （P 〉 0. 05 ） between single and combination of drugs （Х^2 = 1. 437） and between two groups of patients at the end of 12 months. Clinical effect of LEV showed no remarkable difference between different types of epilepsy at the end of 6 months （ Х^2 = 1. 315 ,P 〉 0. 05 ） and 12 months （ Х^2 = 2. 700,P 〉 0. 05 ）. The control rate of epileptic attack was higher in single LEV than in combination drugs （Х^2 = 10. 83,P 〈 0. 05 ）. The total side effects were 13.6%, including somnolence, weakness, anorexia, headache, irritability and forgetfulness. CONCLUSION ： The curative effects of levetiracetam single or in combination are definite, stable and continuous for PS and SGTCS.