妥泰预防热性惊厥的临床及实验研究

Clinical and experimental study of the prophylactic management of febrile seizure with topiramate

目的 观察妥泰 (topiramate ,TPM)单药在预防动物及儿童热性惊厥发作的疗效、价值与毒副反应。方法 挑选 60只对热惊厥敏感的Wistar大鼠和 90例符合CFC诊断的儿童使用妥泰后 ,观察其热性惊厥敏感性改变情况和毒副反应。结果 ①Wistar大鼠用药后 ,入热水浴后发生惊厥的时间明显推迟 (t=3 0 7～ 3 5 9,P <0 0 1) ;而惊厥持续的时间则明显缩短 (t =3 3 3～ 4 18,P <0 0 1) ;同时热惊厥发生的程度也明显减轻 (t =4 89～ 6 65 ,P <0 0 1)。② 90例CFC儿童服用妥泰前后热惊发作次数分别为 ( 8 72± 11 0 7)次 ,( 0 2 4± 0 72 )次 ,差异非常显著 (t=7 2 5 ,P <0 0 1) ;用药前后脑电图比较也有明显改善 ( χ2 =2 0 63 ,P <0 0 1)。③Wistar大鼠和CFC儿童服用TPM后出现神萎、纳差、消瘦等不良反应者分别为65 %( 3 9 60 ) ,13 3 %( 12 90 ) ,两者分别相比差异非常显著 ( χ2 =42 83 12 82 ,P <0 0 1)。结论 TPM用于预防动物和儿童热性惊厥的发生具有临床疗效高 ,使用剂量较小 ,副作用较少等优点 。

Objective To observe the prophylactic effect, curative effect, and side effects of topiramate (TPM) as monotherapy for rats and children with febrile seizure. Methods The susceptiveness to febrile convulsion and side effects were observed in 60 Wistar rats and 90 CFC cases after administration of TPM. Results ① The latent period of febrile seizure in rats exposed to hot bath after treatment with TPM was significantly delayed ( t =3 07-3 59, P <0 01), and even if seizure occurred, the lasting time was significantly shortened ( t =3 33-4 18, P <0 01). The degree of seizure was also significantly reduced ( t =4 89～6 65, P <0 01). ② The attack frequency of seizure in 90 CFC cases after TPM administration dropped significantly from (8 72±11 07) times to (0 24±0 72) times ( t =7 25, P <0 01). Significant improvement on the electroencephalogram (EEG) was also found after administration of TPM (χ 2=20 63, P <0 01). ③ The percentages of the side effects including depression, anorexia, loss of weight, etc. in 60 Wistar rats and 90 CFC cases after administration of TPM were 65% (39/60) and 13 3% (12/90), respectively. Conclusion TPM, with the advantages of small dosage and less side effects, can efficiently prevent febrile seizure in children, so it has a wide application in clinical practice.