4种抗癫痫药单药治疗新诊断癫痫的临床效果及2年保留率比较

Comparision of clinical effect and 2-year retention rate of four antiepileptic drugs in the treatment of newly diagnosed epilepsy

目的比较括丙戊酸钠(VPA)、卡马西平(CBZ)、左乙拉西坦(LEV)及拉莫三嗪(LTG)单药治疗新诊断癫痫的临床效果及2年保留率。方法选取2014年1月至2016年12月于我院就诊的150例新诊断的癫痫患者为研究对象,根据治疗药物的不同将其分为VPA组(58例,VPA单药治疗)、CBZ组(49例,CBZ单药治疗)、LEV组(25例,LEV单药治疗)及LTG组(18例,LTG单药治疗)。比较四组的治疗效果。结果LTG组2年保留率为88.89%,LEV组为80.00%,CBZ组为71.43%,VPA组为65.52%。四组患者的2年保留率比较,差异有统计学意义(P<0.05)。四组患者的治疗总有效率无明显差异(P>0.05)。VPA组及CBZ组停药的主要原因为依从性差,LEV组停药的主要原因为疗效差,LTG组停药的主要原因为皮疹。结论VPA、CBZ、LEV及LTG单药治疗新诊断癫痫的疗效相近,但LTG的2年保留率较高,故建议多采用LTG单药治疗。

Objective To compare the clinical effect and 2-year retention rate of sodium valproate(VPA),carbamazepine(CBZ),levetiracetam(LEV)and lamotrigine(LTG)in the treatment of newly diagnosed epilepsy.Methods A total of 150 newly diagnosed epilepsy patients treated in our hospital from January 2014 to December 2016 were selected as the research objects.According to the different treatment drugs,the patients were divided into VPA group(58 cases,VPA single drug treatment),CBZ group(49 cases,CBZ single drug treatment),LEV group(25 cases,LEV single drug treatment)and LTG group(18 cases,LTG single drug treatment).The therapeutic effects of the four groups were compared.Results The 2-year retention rates of the LTG group,LEV group,CBZ group,VPA group were 88.89%,80.00%,71.43%,65.52%respectively.The 2-year retention rates of the four groups were significantly different(P<0.05).There was no significant difference in the total effective rate of treatment among the four groups(P>0.05).The main reasons for drug withdrawal in the VPA group and CBZ group were poor compliance,the main reason for drug withdrawal in the LEV group was poor efficacy,and the main reason for drug withdrawal in the LTG group was rash.Conclusion Single VPA,CBZ,LEV and LTG have similar efficacy in the treatment of newly diagnosed epilepsy,but the 2-year retention rate of LTG is higher.Therefore,single LTG treatment is recommended to be widely used.