妥泰预防热性惊厥的临床研究

Prophylactic treatment of topiramate in children with febrile seizure

目的 观察妥泰单药在预防儿童热性惊厥发作的疗效、价值与毒副反应。方法 观察符合CFC诊断的 90例儿童使用TPM后热性惊厥敏感性改变情况和毒副反应。结果 (1 ) 90例CFC儿童服用TPM前后热惊发作次数分别为 (8.72± 1 1 .0 7)次 ,(0 .2 4± 0 .72 )次 ,差异非常显著 (t=7.2 5 ,P <0 .0 1 ) ;(2 )完全停止发作为 77/ 90例 (85 .6 % ) ,总有效率 97.7% (88/ 90例 ) ;(3)用药前后脑电图比较也有明显改变 (χ2 =2 0 .6 3,P <0 .0 1 ) ;(4 )CFC儿童服用TPM后出现神萎、嗜睡、纳差、消瘦、不出汗、低热、体重减轻等不良反应者为 1 3.3% (1 2 / 90例 ) ,而无皮疹、白细胞减少和肝肾功异常等改变。结论 TPM用于预防儿童热性惊厥的发生具有临床疗效高 ,不良反应少等优点 。

Objective To observe the prophylactic effect and side effects of topiramate(TPM)with monotherapy in children with febrile seizure(CFC). Methods The changes of sensitivity to febrile seizure and side effects were observed in 90 CFC cases after administration of TPM. Results (1)The frequency of attack was reduced from 8.72±11.07/m to 0.24±0.72 /m after TPM administration and there was a significant difference between them ( t =7.25, P <0.01);(2)The fully free from attack was 77 cases of 90(85.6%) and the general efficiency rate was 97.7%(88/90);(3)The improvment of electroencephalogram (EEG) was also apparent after administration of TPM (χ 2=20.63, P <0.01);(4)The side effects include depressed, lethargy, anorexia, emaciation, no sweating, low fever and loss of weight, etc. The incidence of side effects was 13.3%(12/90), and there was no skin eruption, leucocytopenia, liver and kidney function abnormalities happened. Conclusion TPM can efficiently prevent febrile seizure in children, and it is advisable to used it in clinical practice.