CAJ | 학술논문

目的观察妥泰（TPM）加用治疗成人难治性部分性伴或不伴继发全身性发作（GTCS）的疗效、安全性及耐受性。方法 56例在不动原用抗癫痫药（AEDs）的基础上加用TPM治疗20周，前8周为加量期，后12周为维持治疗的稳定期。治疗前（基础期）记录好发作频率、用药情况、体重等作为自身对照。TPM自25 mg/d开始，逐渐加量，目标剂量为200 mg/d。治疗前及治疗结束各查基础AEDs血药浓度进行比较。治疗结束行全面疗效分析。结果 TPM加用治疗20周后，与基础期发作频率比较，64.29%患者发作频率降低≥50%；25.00%患者发作频率降低≥75%＜100%；16.07%完全不发。不良反应轻至中度，但与合用AEDs的多少有关。50%患者体重可有不同程度的下降。TPM对卡马西平及丙戊酸钠血药浓度影响不大。结论 TPM是治疗难治性部分性伴或不伴继发GTCS的安全有效的药物。
목적관찰타태（TPM）가용치료성인난치성부분성반혹불반계발전신성발작（GTCS）적료효、안전성급내수성。방법 56례재불동원용항전간약（AEDs）적기출상가용TPM치료20주，전8주위가량기，후12주위유지치료적은정기。치료전（기출기）기록호발작빈솔、용약정황、체중등작위자신대조。TPM자25 mg/d개시，축점가량，목표제량위200 mg/d。치료전급치료결속각사기출AEDs혈약농도진행비교。치료결속행전면료효분석。결과 TPM가용치료20주후，여기출기발작빈솔비교，64.29%환자발작빈솔강저≥50%；25.00%환자발작빈솔강저≥75%＜100%；16.07%완전불발。불량반응경지중도，단여합용AEDs적다소유관。50%환자체중가유불동정도적하강。TPM대잡마서평급병무산납혈약농도영향불대。결론 TPM시치료난치성부분성반혹불반계발GTCS적안전유효적약물。
Objective　To observe the effectiveness,safety and tolerability of Topiramate(TPM) as adjunctive therapy in adults with refractory partial epilepsy with or without secondary generalized tonic-clinic seizure (GTCS).Methods　TPM as adjunctive therapy in 56 cases (original therapy with antiepileptic drugs) for 20 weeks,the first 8 weeks for titration phase, the last 12 weeks for stabilization phase of maintain therapy. In baseline phase the seizure frequency, dosage situation,weight were noted,and as the contrast of self.With 25 mg/d TPM as a starting dosage and titration,the target dosage was 200 mg/d.The blood concentration of the AEDs blood compared before and after the treatment,and the therapy was analysed widely by the end of the treatment.Results　After TPM adjunctive therapy for 20 weeks,as compared with the seizure frequency in baseline phase,the seizure frequencies of 64.29% patients were reduced ≥50%;the seizure frequencies of 25% patients ≥75%<100%;16.07% were free.The adverse responses were from mild to moderate,but it related to the dosage of AEDs.The weight of 50% patients reduced in different degree.The effects of the blood concentration weren't great on TPM to carbamazepine and valproate.Conclusion TPM is a safe effective drug for treating adult patients with refractory partial epilepsy with or without secondary GTCS.