左乙拉西坦与卡马西平治疗小儿癫痫部分性发作的疗效比较

Comparison of Efficacy of Levetiracetam and Carbamazepine in the Treatment of Partial Seizures in Children with Epilepsy

目的 :比较左乙拉西坦与卡马西平治疗小儿癫痫部分性发作的疗效及对脑电图的改善效果。方法:选取2015年2月—2016年2月我院收治的90例部分性发作癫痫患儿为研究对象,按随机数字表法分为两组,各45例,A组应用左乙拉西坦(起始剂量10 mg/kg,qd,用药1周后加量10 mg/kg,qd,持续用药1周后再加量10 mg/kg,达到30 mg/kg,qd)治疗,B组应用卡马西平(起始剂量5～7.5 mg/kg,从第2周开始每日加量0.1～0.5 mg/kg,到第4周达到维持剂量12.5～15.0 mg/kg,qd)治疗,比较两组疗效、治疗前后脑电图变化及不良反应。结果 :两组癫痫发作控制总有效率比较,差异无统计学意义(P> 0.05);A组脑电图改善总有效率为84.44%,显著高于B组的62.22%,差异有统计学意义(P <0.05);A组治疗期间不良反应发生率为20.0%,显著低于B组的60.0%,差异有统计学意义(P <0.05)。结论:与卡马西平比较,左乙拉西坦治疗小儿癫痫部分性发作的临床疗效更显著,对脑电图的改善效果更好,安全性更高,值得推广。

Objective: To compare the efficacy of levetiracetam and carbamazepine in the treatment of partial seizures in children with epilepsy and their improvement effect on EEG. Methods: 90 children with partial seizures admitted to our hospital from February 2015 to February 2016 were selected as subjects investigated and randomly divided into two groups. 45 cases in each group. The children in the group A were given levetiracetam (initial dose 10 mg/kg, qd, added 10 mg/kg after one week of administration, qd, added 10 mg/kg after one week of continuous administration to 30 mg/kg, qd), and the children in the group B were given carbamazepine (the initial dose was 5~7.5 mg/kg, qd, and gradually increased at 0.1~0.5 mg/kg per day from the second week until it reached maintenance dose: 12.5~15.0 mg/kg, qd, by the fouth week). The efficacy, EEG changes before and after treatment and adverse reactions were compared between the two groups. Results: There was no significant difference in total effective rate for epileptic seizure control between the two groups (P>0.05). The total effective rate for EEG improvement in the group A was 84.44%, which was significantly higher than 62.22% in the group B (P<0.05). The incidence of adverse reactions in the group A was 20.0%, which significantly lower than 60.0% in the group B (P<0.05). Conclusion: Compared with carbamazepine, levetiracetam is more effective in treating partial seizures in children with epilepsy, and has better improvement effect on EEG and higher safety, which is worth popularizing.