CAJ | 학술논문

目的采用左乙拉西坦(LEV)预防儿童热性惊厥(FS)的复发,并随访观察其疗效和安全性.方法将2011年8月至11月在江西省儿童医院住院或门诊就诊的63例反复FS患儿按先后顺序分为对照组、低剂量组和高剂量组,其中对照组患儿体温在38.5 ℃以上时给予退热治疗;高、低剂量组在对照组的基础上,当患儿开始发热时分别口服LEV每次30 mg/kg和15 mg/kg,每日2次,维持1周,然后减量,第8-12天减为每次20 mg/kg和10 mg/kg,每日2次,第13-15天继续减为每次10 mg/kg和5 mg/kg,每日2次,第16天停药.3组均随访观察1年,每3个月随访1次,随访内容包括发热次数、惊厥复发次数、用药情况及药物不良反应.结果 3组复发例数分别为11例、4例、3例,复发率分别为52.38％、19.05％、14.29％,平均复发次数分别为(0.76±1.00)次、(0.19 ±0.40)次、(0.14 ±0.36)次;对照组复发次数显著高于治疗组(P＜0.05),但低剂量组与高剂量组间差异无统计学意义(P=0.951).低剂量组2例FS患儿出现轻度嗜睡症状,高剂量组1例FS患儿出现轻度兴奋、冲动及暴躁等症状.不良反应发生率分别为9.52％(2/21例)和4.76％(1/21例),且2组间比较差异无统计学意义(P=1.000).结论 LEV可有效预防反复FS的患儿复发,且小剂量即可达到大剂量相似的预防效果,同时具有不良反应少,耐受性良好等特点.
목적 채용좌을랍서탄(LEV)예방인동열성량궐(FS)적복발,병수방관찰기료효화안전성.방법 장2011년8월지11월재강서성인동의원주원혹문진취진적63례반복FS환인안선후순서분위대조조、저제량조화고제량조,기중대조조환인체온재38.5 ℃이상시급여퇴열치료;고、저제량조재대조조적기출상,당환인개시발열시분별구복LEV매차30 mg/kg화15 mg/kg,매일2차,유지1주,연후감량,제8-12천감위매차20 mg/kg화10 mg/kg,매일2차,제13-15천계속감위매차10 mg/kg화5 mg/kg,매일2차,제16천정약.3조균수방관찰1년,매3개월수방1차,수방내용포괄발열차수、량궐복발차수、용약정황급약물불량반응.결과 3조복발례수분별위11례、4례、3례,복발솔분별위52.38％、19.05％、14.29％,평균복발차수분별위(0.76±1.00)차、(0.19 ±0.40)차、(0.14 ±0.36)차;대조조복발차수현저고우치료조(P＜0.05),단저제량조여고제량조간차이무통계학의의(P=0.951).저제량조2례FS환인출현경도기수증상,고제량조1례FS환인출현경도흥강、충동급폭조등증상.불량반응발생솔분별위9.52％(2/21례)화4.76％(1/21례),차2조간비교차이무통계학의의(P=1.000).결론 LEV가유효예방반복FS적환인복발,차소제량즉가체도대제량상사적예방효과,동시구유불량반응소,내수성량호등특점.
Objective To evaluate the clinical efficacy and safety of Levetiracetam (LEV) for prophylaxis of febrile seizures(FS) recurrence in children and provide a new approach to treatment.Methods Approved by their guardians,63 cases were collected from the inpatients or outpatients in Jiangxi Children's Hospital from Aug.to Nov.2011.They were randomly divided into a control group,low dose LEV group and high dose LEV group.When they had a fever of 38.5 ℃ or higher,only antipyretic was given in the control group.However,LEV was given to the other 2 groups additionally and dosages were:high dose group,D1-D7 (30 mg/kg),D8-D12 (20 mg/kg),D13-D15 (10 mg/kg),twice a day;low dose group,D1-D7 (15 mg/kg),D8-D12 (10 mg/kg),D13-D15 (5 mg/kg),twice a day.All patients were followed-up every 3 months for 1 year,recording the frequency of fever and seizures recurrence,medication compliance and side effects.Results Eleven cases,4 cases and 3 cases experienced FS recurrences in the control group,the low dose group and high dose group,respectively,and the recurrence rates were 52.38％,19.05％ and 14.29％,respectively.The average episodes of FS recurrence were (0.76 ± 1.00) times,(0.19 ±0.40) times and (0.14 ± 0.36) times per year among 3 groups,respectively.The recurrence rate of FS in control group was higher than that in treatment groups(P ＜ 0.05),but there was no significant difference between 2 treatment groups (P =0.951).Two cases who had mild somnolence in low dose group and only 1 case had mild excitement,impulse and bad-tempered slightly in high dose group.The rates of side effects were 9.52％ (2/21 cases)and 4.76％ (1/21 case),and there was no significant difference between them(P =1.000).Conclusions LEV can effectively prevent the recurrence of FS in children,and the efficacy of the low dose group is similar to that of the high dose group.Compared with the high dose group,there are less side effects but well-tolerance in the low dose group.