CAJ | 학술논문

目的研究单用或加用托吡酯治疗老年癫痫患者的疗效和不良事件.方法在一项托吡酯治疗癫痫的多中心开放实验中.对全国52家医院门诊病例的119例60岁以上的老年癫痫患者疗效进行分析.剂量采用8周加量期到200 mg/d,接着是12周的稳定期,治疗期间每月随访一次.结果稳定期结束后,119例患者中有106例(89.1%)发作减少超过50%.119例患者中65例单用托吡酯治疗.有效率为93.8%,54例合并用药,有效率为83.8%.各种类型癫痫患者单用或加用托吡酯治疗后,发作完全控制的患者的例数均超过50%.单用或加用托吡酯治疗病程分别为小于1年、1～3年、4～6年、大于6年的患者的发作减少频数分别为92.86%、91.67%、100%、94.44%和80.00%、85.71%、70.00%、86.36%.合并用卡马西平、丙戊酸钠、苯妥英钠、苯巴比妥、安定的患者总有效率分别为:79.41%、87.50%、85.71%、0%、80%.单用托吡酯治疗老年患者副作用程度较轻.结论托吡酯无论单用或加用治疗老年癫痫患者,在稳定期结束后发作次数均明显减少,单用副作用程度较轻.不同的发作类型、基础病程、加用药物对疗效无明显影响.
목적 연구단용혹가용탁필지치료노년전간환자적료효화불량사건.방법 재일항탁필지치료전간적다중심개방실험중.대전국52가의원문진병례적119례60세이상적노년전간환자료효진행분석.제량채용8주가량기도200 mg/d,접착시12주적은정기,치료기간매월수방일차.결과 은정기결속후,119례환자중유106례(89.1%)발작감소초과50%.119례환자중65례단용탁필지치료.유효솔위93.8%,54례합병용약,유효솔위83.8%.각충류형전간환자단용혹가용탁필지치료후,발작완전공제적환자적례수균초과50%.단용혹가용탁필지치료병정분별위소우1년、1～3년、4～6년、대우6년적환자적발작감소빈수분별위92.86%、91.67%、100%、94.44%화80.00%、85.71%、70.00%、86.36%.합병용잡마서평、병무산납、분타영납、분파비타、안정적환자총유효솔분별위:79.41%、87.50%、85.71%、0%、80%.단용탁필지치료노년환자부작용정도교경.결론 탁필지무론단용혹가용치료노년전간환자,재은정기결속후발작차수균명현감소,단용부작용정도교경.불동적발작류형、기출병정、가용약물대료효무명현영향.
Objective To assess the efficacy and adverse-event profile of monotherapy oradd-on therapy with topiramate in elderly patients with epilepsy. Methods A multicenter, prospective,open-label, observational study of topiramate, for either monotherapy or add-on therapy, was performedamong 119 elderly patients with epilepsy in the Outpatient Department of Neurology of 52 generalhospitals in China. After the baseline evaluation, topiramate was given at the target dose of 200 mg/dayover an 8-week titration period. In the subsequent 12-week maintenance period, the topiramate dose wasadjusted (200-300 mg) according to the clinical results. The patients were followed up for 6 months, withmonthly visits and regular physical, neurological and laboratory examinations. Results After themaintenance period, 106 patients (89.1%) showed a seizure frequency reduction by 50% or greater fromthe baseline, among whom 65 patients(93.8%)received the monotherapy and 54(83.8%) had the add-ontherapy. Topiramate monotherapy and add-on therapy resulted in a complete seizure control in over 50%of the patients with various types of seizure. In patients with disease course less than 1 year, between 1and 3 years, between 4 and 6 years, and over 6 years, topiramate monotherapy resulted in seizurereduction by 92.86%, 91.67%, 100%, and 94.44%, and the add-on therapy reduced the seizure by80.00%, 85.71%, 70.00%, and 86.36%, respectively. When combined with carbamazepine, valproatesodium, phenytoin, phenol barbital, and diazepam, the total effective rate oftopiramate was 79.41%,87.50%, 85.71%, 0%, and 80.00%, respectively. Topiramate, especially in monotherapy, caused onlymild or moderate adverse effects. Conclusion Topiramate is effective and safe for either monotherapyor add-on therapy of epilepsy in elderly patients. The types of epilepsy, disease course, or the drugs usedin the add-on therapy do no obviously affect the efficacy of topiramate for seizure control.