左乙拉西坦、拉莫三嗪、卡马西平治疗成人局灶性癫痫的疗效:一项前瞻性研究

Therapeutic efficacy of levetiracetam,lamotrigine,and carbamazepine monotherapy among adult patients with focal epilepsy:A prospective study

目的:观察左乙拉西坦(l evetiracetam,LEV)、拉莫三嗪(lamotrigine,LTG)、卡马西平(carbamazepine,CBZ)单药治疗成人局灶性癫痫的临床疗效及安全性。方法:选取2018年8月至2019年10月于徐州医科大学附属医院就诊的1 3 8例成人局灶性癫痫患者,随机分为L E V组、 LTG组、CBZ组,选用LEV、LTG、CBZ单药治疗,通过≥12个月的随访,记录患者的临床疗效、保留率、首次发作时间、药物保留时间和不良反应。结果:3组患者总体疗效、总有效率、保留率的差异无统计学意义(P>0.05);LTG组的12个月癫痫无发作率(81.6%)较CBZ组(56.8%)高,且结果经校正后具有统计学意义(P<0.0167);LTG组首次发作时间(平均252.5 d)较LEV组(平均44.5 d)及CBZ组(平均119.5d)存在优势,差异具有统计学意义(P<0.0167);LEV组、LTG组、CBZ组在药物保留时间方面的差异无统计学意义(P>0.05)。结论:3种药物中LTG在首次发作时间上较LEV及CBZ长,且LTG的12个月癫痫无发作率显著高于CBZ;3种药物总体疗效及安全性的差异无统计学意义。

Objective:To observe the therapeutic efficacy and safety of levetiracetam(LEV),lamotrigine(LTG),and carbamazepine(CBZ) monotherapy in adults with focal epilepsy.Methods:Totally 138 adult patients with focal epilepsy from August 2018 to October 2019 in our hospital were recruited.Patients were randomly divided into LEV group,LTG group,and CBZ group,and LEV,LTG,and CBZ monotherapy were used.Clinical efficacy,retention rate,time of first attack,drug retention time,and adverse reactions were recorded through ≥12 months of follow-up.Results:There were no significant differences in the overall curative effect,total effective rate,and retention rate among the 3 groups(P>0.05).The 12-month seizure-free rate of LTG group(81.6 %) was higher than that of CBZ group(56.8 %),and the results were statistically significant after correction(P<0.0167).There was a statistically significant difference in the time to first seizure in the LTG group(mean 252.5 d) compared to the LEV group(mean 44.5 d) and the CBZ group(mean 119.5 d)(P<0.0167).There was no significant difference in the time of drug retention among the 3 groups(P>0.05).Conclusion:Patients with focal epilepsy treated with LTG present a longer time to first seizure than those treated with LEV and CBZ,and the seizure-free rate in LTG group is higher than that of CBZ.There is no significant difference in the overall efficacy and safety of the three drugs.