2019 年第 1 期 第 14 卷

托吡酯大剂量冲击疗法治疗小儿癫jian的效果及安全性评价

Effect and safety of high dose topiramate pulse therapy on epilepsy in children

作者：张晓青孙素真唐洪侠杜雅坤吴文娟李鑫

英文作者：

单位：050031石家庄，河北省儿童医院神经内科

英文单位：

关键词：小儿癫；托吡酯；大剂量冲击疗法

英文关键词：

• 摘要：

• 【摘要】目的    探讨托吡酯大剂量冲击疗法治疗小儿癫的效果及安全性。方法    选取2015年6月至2017年6月河北省儿童医院收治的癫患儿63例，按照随机数字表法分为对照组（31例）和观察组（32例）。2组患儿均给予托吡酯口服，对照组首次剂量为1 mg/（kg·d），若无严重不良反应，逐渐增加至6 mg/（kg·d）；观察组起始剂量为10 mg/（kg·d），连续给药2 d，继以10 mg/（kg·d），分2次服用，连用3 d，逐渐降低至维持剂量7～8 mg/（kg·d）。2组疗程均为3个月。随访6个月，比较2组患儿住院时间、癫发作减少率、疗效、放电指数和不良反应发生情况。结果    2组患儿住院时间比较，差异无统计学意义（P=0.136），观察组患儿癫发作减少率明显高于对照组［（75±8）%比（61±7）%］，差异有统计学意义（P=0.026）。观察组治疗总有效率明显高于对照组［93.8%（30/32）比77.4%（24/31）］，差异有统计学意义（P=0.016）。治疗后，观察组患儿放电指数明显低于对照组，差异有统计学意义（P=0.038）。2组患儿不良反应发生率比较差异无统计学意义（P＞0.05）。结论    托吡酯大剂量冲击疗法治疗小儿癫能够有效控制患儿癫发作，减少大脑异常放电，且不良反应可控，具有一定的临床应用价值。

• 【Abstract】Objective    To explore the clinical effect and safety of high dose topiramate pulse therapy on epilepsy in children. Methods    Sixty-three children with epilepsy admitted to Children′s Hospital of Hebei Province from June 2015 to June 2017 were randomly divided into control group(31 cases) and observation group(32 cases). The control group was given topiramate orally at an initial dose of 1 mg/（kg·d）, which gradually increased to 6 mg/（kg·d） if there was no serious adverse reaction. The observation group was given topiramate at an initial dose of 10 mg/（kg·d） once daily for 2 days, followed by 10 mg/（kg·d） twice daily for 3 days; the dosage gradually reduced to 7-8 mg/（kg·d）. Both groups were treated for 3 months and followed for 6 months. Hospitalization time, decrease rate of epileptic seizure, the curative effect, discharge index and adverse reactions were analyzed. Results    There was no significant difference of hospitalization time between groups（P=0.136）. The decrease rate of epileptic seizure in observation group was significantly higher than that in control group［（75±8）% vs （61±7）%］（P=0.026）. The total effective rate in observation group was significantly higher than that in control group［93.8%（30/32） vs 77.4%（24/31）］（P=0.016）. After treatment, the discharge index in observation group was significantly lower than that in control group（P=0.038）. There was no significant difference of the incidence of adverse reactions between groups（P＞0.05）. Conclusion    High dose topiramate pulse therapy in children with epilepsy can effectively reduce abnormal brain discharge and epileptic seizure; the adverse reactions are tolerable.