341例癫痫患儿用药特点分析

Medication Characteristics in 341 Children with Epilepsy

目的:探讨癫痫患儿临床用药特点,为临床合理应用抗癫痫药物提供参考。方法:回顾性分析2018年2-8月西北妇女儿童医院和西安交通大学第二附属医院收治的341例癫痫患儿临床资料,对其用药方案及癫痫发作控制率进行统计分析。结果:341例癫痫患儿中,男女比例1.04∶1,年龄9个月~19岁,其中>1~3岁患儿占比最大,为32.56%。经抗癫痫药物治疗,341例患儿Ⅱ级以上总体发作控制率为84.45%。单药治疗、双药治疗、三种联合治疗及三种以上联合治疗Ⅱ级以上控制率分别为94.45%、85.14%、69.64%和45.45%。单药治疗中使用率前3位的药物分别为左乙拉西坦、苯巴比妥和丙戊酸钠;多药治疗中使用率前3位的药物分别为左乙拉西坦、丙戊酸钠和托吡酯。单药治疗以左乙拉西坦为主,联合治疗以左乙拉西坦+丙戊酸钠或托吡酯为主。结论:儿童癫痫发病以婴幼儿期最多,药物治疗总体控制率较高,新型抗癫痫药物和传统抗癫痫药物在治疗选择中使用率相当,新型抗癫痫药物左乙拉西坦在各发作类型及各种治疗方案中使用率最高。治疗药物选择主要为左乙拉西坦、苯巴比妥和丙戊酸钠,抗癫痫药物联合治疗方案主要为丙戊酸钠+左乙拉西坦和丙戊酸钠+氯硝西泮+左乙拉西坦。

Objective: To probe into the medication characteristics of children with epilepsy, so as to provide reference for clinical medication. Methods: Retrospective analysis was performed on the clinical data of 341 children with epilepsy treated in Northwest Women and Children’s Hospital and the Second Affiliated Hospital of Xi’an Jiaotong University from Feb. to Aug. 2018, and the drug regimen and control rate of epilepsy were statistically analyzed. Results: Of the 341 children with epilepsy, the ratio of male to female was 1.04∶1, and the age ranged from 9 months to 19 years old, the number of children >1 to 3 years old took the lead, accounting for 32.56%. After antiepileptic drug treatment, the overall control rate of epilepsy in 341 children with grade Ⅱ or higher was 84.45%. The control rates of grade Ⅱ or higher were 94.45%, 85.14%, 69.64% and 45.45% for monotherapy, dual drug therapy, combination of three drugs and combination of more than three drugs, respectively. The top three drugs used in monotherapy were levetiracetam, phenobarbital and sodium valproate, and the top three drugs used in combination of three or more drugs were levotiracetam, sodium valproate and topiramate. Monotherapy was based on levetiracetam, and drug combination was based on levetiracetam + sodium valproate or topiramate. Conclusion: The incidence of epilepsy in children is most common in infants and young children, and the overall control rate of drug treatment is relatively high. The use rate of new antiepileptic drugs and traditional antiepileptic drugs is similar in the treatment selection. Levetiracetam, a new kinds of antiepileptic drugs, has the highest use rate among different types of epilepsy and treatment regimens. The main therapeutic drugs are levetiracetam, phenobarbital and sodium valproate, and the main drug combination regimens are sodium valproate + levetiracetam and sodium valproate + clonazepam + levetiracetam.