托吡酯单药治疗儿童癫癎的临床研究

Study on topiramate as monotherapy in the treatment of childhood epilepsy

目的:研究托吡酯单药治疗儿童癫癎的临床应用价值。方法:选择未用抗癫癎药物治疗,或既往用抗癫癎药物治疗,停药≥1个月的癫癎患儿250例。均给予托吡酯治疗,剂量由1mg/kg·d开始,每周增加1mg/kg·d,直至临床发作控制,或达4～8mg/kg·d。3个月后观察其疗效。并同时观察不良反应。结果:250例患儿共有241例完成全部随访。托吡酯单药治疗有效剂量为2～6mg/kg·d,癫癎发作频率减少≥50%者为199例(82.57%),≥75%者为147例(61%),减少100%者为96例(39.83%),<50%者为42例(17.43%)。最常见的不良反应为体重不增或降低、食欲减退、嗜睡、出汗减少、体温升高等。结论:托吡酯单药治疗儿童癫癎安全有效。

Objective:To evaluate the efficacy of topiramate in childhood epilepsy.Methods :250epileptic pediatric cases that had never received with treatment of anti-epilepsy drugs were given topiramate as monotherapy and were followed up for more than3months.Result:There was a50%or greater reduction in seizure frequency in199cases(82.57%)of all topiramate-treated patients,a75%or greater reduction in147cases(61%),and100%reduction,or seizure free,in96cases(39.83%)during the study.The effective dosages of topiramate were2～6mg /kg·d for children.Adverse ef-fects,including weight decrease,anorexia,and events related to the central nevous system tended to be mild to moderate in severity.Conclusion:Accumulating evidence suggests that topiramate has a broad spectrum of antiepileptic effect and,therefore,is an effective medicine for childhood epilepsy.