不同方案治疗Lennox-Gastaut综合征的近远期疗效及安全性比较

Short-and long-term efficacies and safety of different regimens for Lennox-Gastaut syndrome:a comparative study

目的比较夜间口服丙戊酸钠及奥卡西平治疗Lennox-Gastaut综合征(LGS)的近远期疗效及安全性。方法将122例LGS患儿分为观察组与对照组各61例,观察组给予夜间口服大剂量丙戊酸钠治疗,对照组给予夜间口服大剂量奥卡西平治疗,起始剂量均为5~10 mg/(kg·d),逐渐增加至20~30 mg/(kg·d)。比较两组患儿近期治疗总有效率、不良反应情况、治疗前后认知功能评分及治疗后1年的脑电图改善情况。结果治疗3个月后,观察组近期治疗总有效率高于对照组(P<0.05)。观察组治疗期间不良反应发生率低于对照组(P<0.05)。两组治疗后认知功能评分高于治疗前,且观察组高于对照组(P<0.05)。随访1年,观察组远期脑电图改善率高于对照组(P<0.05)。结论与奥卡西平比较,夜间口服较大剂量丙戊酸钠治疗LGS患儿能更好地提高近期治疗效果,减少不良反应的发生,改善患儿认知功能,并促进患儿远期脑电图检查的恢复。

Objective To investigate the short-and long-term efficacies and safety of night medication of oral valproate and oxcarbazepine for the treatment of Lennox-Gastaut syndrome(LGS).Methods A total of 122 children with LGS were divided into observation group and control group,with 61 cases in each group.The observation group and the control group were treated with large doses of oral valproate and oxcarbazepine respectively at night,with an initial dose of 5-10 mg/kg daily,and the dose increased to 20-30 mg/kg daily gradually.The total effective rate of short-term therapy,adverse reactions,cognitive function scores before and after treatment,and EEG improvement after 1 year of treatment were compared between the two groups.Results After 3 months of treatment,the total effective rate of short-term therapy in the observation group was higher than that in the control group(P<0.05).During treatment,the incidence rate of adverse reactions in the observation group was lower than that in the control group(P<0.05).After treatment,the cognitive function scores in the two groups were higher compared to those before treatment(P<0.05),and the score in the observation group was higher than that in the control group(P<0.05).After a 1-year followed-up,the improvement rate of long-term EEG in the observation group was higher than that in the control group(P<0.05).Conclusion Compared to oxcarbazepin,night medication of large dose of oral valproate can better improve the short-term efficacy,reduce the incidence of adverse reactions,improve the cognitive function,and promote the long-term EEG improvement in the treatment of children with LGS.