本文選題：熱性驚厥　切入點：預(yù)防　出處：《吉林大學(xué)》2012年碩士論文

【摘要】：背景與目的：FS是小兒驚厥最常見的原因，復(fù)發(fā)率高，且癲癇發(fā)生率遠(yuǎn)遠(yuǎn)高于一般人群。目前主要通過間斷應(yīng)用DZP和長期口服VPA或PB來預(yù)防復(fù)發(fā)，有效率為70～80%，但這些藥物的不良反應(yīng)明顯，甚至超過了治療作用。LEV為新型AED，作用機制獨特，起效迅速，有良好的抗癲癇療效和安全性。近年來動物試驗研究表明LEV預(yù)防FS復(fù)發(fā)的有效性與VPA、PB相似，且副作用小。本研究旨在評價該藥在預(yù)防FS復(fù)發(fā)方面的臨床有效性與安全性，并與空白對照組比較，為FS的復(fù)發(fā)用藥提供新選擇。 方法：收集2010年9月～2012年2月就診于吉林大學(xué)第一醫(yī)院小兒神經(jīng)科的FS患兒81例，經(jīng)監(jiān)護人同意后，行血電解質(zhì)、肝腎功能、血常規(guī)、尿常規(guī)和24小時動態(tài)腦電圖(24-hour ambulatory electroencephalogram，24hAEEG)等檢查。隨機分為對照組、低劑量組、高劑量組三組，體溫超過37.5℃時對照組僅口服退熱藥，治療組分別口服左乙拉西坦片20mg/(kg·d)、40mg/(kg·d)，，連續(xù)口服5天后停藥，同時體溫超過38.5℃時口服退熱藥。每3個月隨訪1次，記錄發(fā)熱次數(shù)、FS復(fù)發(fā)次數(shù)、服藥情況、藥物不良反應(yīng)，每半年復(fù)查24hAEEG1次，共隨訪1年～1年半。若出現(xiàn)2次無熱驚厥或1次無熱驚厥伴24hAEEG癲癇樣放電則診斷為癲癇。 結(jié)果：(1)FS復(fù)發(fā)情況對比：對照組、低劑量組及高劑量組入組患兒分別為27例、28例、26例，三組復(fù)發(fā)例數(shù)分別為13例、5例、4例，復(fù)發(fā)率分別為48.1%、17.9%、15.4%，平均復(fù)發(fā)次數(shù)分別為2.38±0.48次、1.60±0.54次、1.50±0.50次，對照組與兩個治療組比較差異均有統(tǒng)計學(xué)意義，高、低劑量組間比較差異無統(tǒng)計學(xué)意義。SFS和CFS復(fù)發(fā)率在低、高劑量組間對比差異無統(tǒng)計學(xué)意義。(2)癲癇發(fā)生率對比：對照組、低劑量組、高劑量組分別有2例、1例、1例診斷為癲癇，發(fā)生率各為7.4%、3.6%、3.8%，對照組發(fā)生率高于治療組，但組間兩兩對比差異均無顯著性。(3)不良反應(yīng)：低劑量組僅1例出現(xiàn)輕度興奮，高劑量組出現(xiàn)興奮、沖動各2例，嗜睡、頭暈各1例，不良反應(yīng)發(fā)生率分別為3.6%、23.1%，兩組間對比差異有顯著性。 結(jié)論：(1) LEV可以有效預(yù)防小兒FS復(fù)發(fā)。(2)LEV不能降低FS患兒的癲癇發(fā)生率。(3)觀察過程中高劑量組不良反應(yīng)發(fā)生率高于低劑量組，但均未出現(xiàn)嚴(yán)重副反應(yīng)。
[Abstract]:Background and objective: FS is the most common cause of infantile convulsion. The recurrence rate is high and the incidence of epilepsy is much higher than that of the general population. At present, recurrent seizures are mainly prevented by intermittent use of DZP and long-term oral administration of VPA or PB. The effective rate was 70% and 80%, but the adverse effects of these drugs were obvious, even more than the therapeutic effect. LEV was a new type of AED.The mechanism of action was unique and the effect was rapid. It has good antiepileptic efficacy and safety. In recent years, animal studies have shown that the efficacy of LEV in preventing the recurrence of FS is similar to that of VPAP, and the side effects are small. The purpose of this study was to evaluate the clinical efficacy and safety of LEV in preventing the recurrence of FS. Compared with the blank control group, it provides a new choice for the recurrence of FS. Methods: from September 2010 to February 2012, 81 patients with FS in the Department of Pediatric Neurology, first Hospital of Jilin University, were collected. Blood electrolytes, liver and kidney function, blood routine examination were performed with the consent of guardian. Urine routine and 24 hour ambulatory electroencephaloencephaloencephalogram (AEGG) were randomly divided into three groups: control group, low dose group, high dose group, and the control group only took antipyretic when body temperature was over 37. 5 鈩

本文編號：1684668