吡仑帕奈添加治疗儿童局灶性癫痫的疗效及影响因素

Efficacy and influencing factors of add-on perampanel in the treatment of focal epilepsy in children

目的研究吡仑帕奈(Perampanel,PER)添加治疗儿童局灶性癫痫的疗效及影响因素,为儿童局灶性癫痫的治疗提供参考。方法回顾性分析2021年1月至2022年1月就诊于徐州医科大学附属医院儿科门诊或病房添加PER治疗的局灶性癫痫患儿的临床资料,评估患儿添加PER治疗后的疗效及安全性;同时根据患儿12个月时的疗效分组,对两组患儿临床资料进行统计学比较,找出影响疗效的因素并进行分析。结果共纳入研究对象86例,添加PER治疗12个月后的无发作率和总有效率分别为30.2%和68.6%,12个月的药物保留率为76.7%;无效组患儿的病程、用药数量与有效组患儿差异有统计学意义(P<0.05),有效组中发作类型为局灶扩布至双侧强直-阵挛发作的患儿比例显著高于无效组(P<0.05);PER治疗有效率与病程、添加PER前服药数量呈负相关(P<0.05),与局灶扩布至双侧强直-阵挛发作这种发作类型呈正相关(P<0.05);不良反应发生率为36.0%。结论PER添加治疗儿童局灶性癫痫具有较好的疗效及安全性;越早添加、合并用药数量越少,疗效可能越好,对于局灶扩布至双侧强直-阵挛发作的患儿可能疗效更好。

Objective To study the efficacy and influencing factors of add-on perampanel(PER)in the treatment of focal epilepsy in children,and provide reference for future treatment for children with focal epilepsy.Methods From January 2021 to January 2022,the clinical data of children with focal epilepsy treated in pediatric outpatient department or ward of Affiliated Hospital of Xuzhou Medical University were analyzed retrospectively,and the efficacy and safety of the treatment were evaluated.At the same time,the children were divided into groups according to the curative effect at 12 months.The clinical data of the two groups were compared statistically,and the factors affecting the curative effect were analyzed.Results A total of 86 patients were included in the study.The seizure-free rate and the total effective rate were 30.2%and 68.6%,respectively,and the drug retention rate at 12 months was 76.7%.There were significant differences in the course of disease and the number of drugs between the ineffective group and the effective group(P<0.05);the proportion of children with focal to bilateral tonic-clonic seizures in the effective group was significantly higher than that in the ineffective group(P<0.05);the effective rate of PER was negatively correlated with the course of disease and the number of drugs taken before add-on PER(P<0.05)but was positively correlated with the seizures type of expansion from focal to bilateral tonic-clonic seizures(P<0.05);the incidence of adverse reactions was 36.0%.Conclusion The addition of PER has good efficacy and safety in the treatment of children with focal epilepsy,the earlier the addition and the less the number of drugs,the better the curative effect may be.It may be more effective for children with focal to bilateral tonic-clonic seizures.