發(fā)布時(shí)間：2018-04-22 21:06

  本文選題：癲癇 + 左乙拉西坦　； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：目的 左乙拉西坦（Levetiracetam，LEV）是一種新型抗癲癇藥物（AEDs），有獨(dú)特的抗癲癇作用機(jī)制。1999年本品獲美國(guó)FDA批準(zhǔn)，用于成人部分性癲癇發(fā)作的添加治療，2005年歐盟批準(zhǔn)左乙拉西坦單藥治療癲癇部分性發(fā)作伴或不伴繼發(fā)性全面性發(fā)作的16歲以上新診斷的癲癇。2007年3月在我國(guó)批準(zhǔn)上市，適用于成人及4歲以上兒童癲癇患者部分性發(fā)作的添加治療。本文主要研究左乙拉西坦(LEV)添加和單藥治療成人癲癇的臨床療效及安全性。 方法 共有147例成人癲癇患者納入本研究，其中102例為既往診斷明確的癲癇患者，并正在服用1種或1種以上一線抗癲癇藥物，未能完全控制，予LEV添加治療。45例為新診斷的未經(jīng)治療的各類型成人癲癇患者，予LEV單藥治療。并進(jìn)行24周開放性自身對(duì)照隨訪研究，觀察治療的有效性及安全性。 結(jié)果 治療24周后，LEV添加治療患者癲癇發(fā)作完全控制率19.6％，總有效率79.4％；單純部分性發(fā)作組中，完全控制4例（15.4％），顯效12例（46.2％），有效5例（19.2％），無效5例（19.2％）；復(fù)雜部分性發(fā)作組中，完全控制5例（17.9％），顯效10例（35.7％），有效9例（32.1％），無效4例（14.3％）；部分繼發(fā)全面性發(fā)作組中，完全控制8例（25.8％），顯效9例（29％），有效6例（19.4％），無效8例（25.8％），全面性發(fā)作組中，完全控制3例（17.6％），，顯效6例（35.3％），有效4例（23.5％），無效4例（23.5％）。4組療效比較差異無統(tǒng)計(jì)學(xué)意義。45例LEV單藥治療患者癲癇發(fā)作完全控制率20.0％,總有效率86.7%。部分性發(fā)作組中，完全控制5例(23.8％)，顯效7例（33.3％），有效6例(28.6％)，無效2例(9.5％)，加重1例(4.8％)；全面性發(fā)作組例中，完全控制4例(16.7％)，顯效9例（37.5％），有效8例(33.3％)，無效2例(8.3％)，加重1例(4.2％)。2組療效比較差異無統(tǒng)計(jì)學(xué)意義。使用左乙拉西坦治療6-12個(gè)月后均復(fù)查腦電圖，12例(8.2％)患者癇性放電消失，71例(48.3％)腦電圖癇性放電減少大于50％，64例(43.5％)腦電圖改善不明顯，無腦電圖加重者，緩解率占56.5％。左乙拉西坦治療期間26.5％(39/147)患者出現(xiàn)不良反應(yīng)。不良反應(yīng)主要有嗜睡乏力、頭暈、惡心嘔吐、食欲下降等，未予特殊處理，2-8周后自行緩解，沒有病例因嚴(yán)重不良反應(yīng)而退出。 結(jié)論 1.左乙拉西坦添加和單藥治療對(duì)各種發(fā)作類型的成人癲癇均有療效。 2.左乙拉西坦添加和單藥治療成人癲癇腦電圖癇性放電減少大于50%。 3.左乙拉西坦添加和單藥治療成人癲癇不良反應(yīng)發(fā)生率低，持續(xù)時(shí)間短，并均為可耐受程度。
[Abstract]:objective
Levetiracetam (LEV) is a new type of antiepileptic drug (AEDs), which has a unique anti epileptic mechanism for.1999 year. This product was approved by the United States FDA for adult partial epileptic seizures. In 2005, the European Union approved levetiracetam for the treatment of partial seizures with or without secondary total seizures at 16 years of age. The newly diagnosed epilepsy was approved in China in March.2007, which is suitable for the treatment of partial seizures in adults and children over 4 years of age. This paper mainly studies the clinical efficacy and safety of LEV addition and single drug treatment for adult epilepsy.
Method
A total of 147 adult epileptic patients were included in this study, of which 102 were diagnosed as previously diagnosed epileptic patients and were taking 1 or more than 1 first-line antiepileptic drugs and failed to complete control. LEV was added to.45 as a newly diagnosed type of untreated adult epileptic patients, given LEV single drug treatment and 24 weeks open self. Follow up study was conducted to observe the efficacy and safety of the treatment.
Result
After 24 weeks of treatment, the total control rate of epileptic seizures in LEV patients was 19.6%, the total effective rate was 79.4%, 4 cases (15.4%), 12 cases (46.2%), 5 cases (19.2%), and 5 cases (19.2%) in the simple partial seizure group. 1%), 4 cases (14.3%) were ineffective, 8 cases (25.8%), 9 cases (29%), 6 cases (19.4%), 8 cases (25.8%), totally controlled 3 cases (17.6%) in the total seizure group, and there was no significant difference in the curative effect of the.4 group with no statistical significance.45 The total control rate of epileptic seizures in patients with LEV was 20%. In the total effective 86.7%. partial seizure group, 5 cases (23.8%) were completely controlled, 7 cases (33.3%), 6 cases (28.6%), 2 cases (9.5%), and 1 cases (4.8%). Effective 2 cases (8.3%), aggravated 1 cases (4.2%).2 group curative effect comparison difference has no statistically significant difference. The use of Zuo Yi Lacita treatment 6-12 months after the reexamination of electroencephalogram, 12 cases (8.2%) of epileptic discharge disappeared, 71 cases (48.3%) electroencephalogram epileptic discharge decreased more than 50%, 64 cases (43.5%) electroencephalogram improvement is not obvious, no electroencephalograph aggravation, remission rate 26.5% (39/147) patients had adverse reactions during the treatment of 56.5%. levetiracetam. The main adverse reactions were lethargy, dizziness, nausea and vomiting, loss of appetite and so on. No special treatment was given. After 2-8 weeks, no cases were withdrawn from serious adverse reactions.
conclusion
1. levetiracetam plus monotherapy is effective in treating adult epilepsy with various seizures.
2. the incidence of epileptic discharge in adult epilepsy with levetiracetam added and monotherapy decreased more than 50%.
3. levetiracetam plus and monotherapy had a low incidence of ADR in adults, with short duration and tolerability.

【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 李玉生;黃圣明;黃希順;;左乙拉西坦治療癲癇的臨床研究[J];醫(yī)藥論壇雜志;2010年06期

2 戴兵;高覺民;;難治性癲癇的中醫(yī)藥治療進(jìn)展[J];內(nèi)蒙古中醫(yī)藥;2010年02期

3 楊忠旭;張穎;歷俊華;張紹東;萬虹;翟晶;;神經(jīng)干細(xì)胞移植治療顳葉癲癇的近期效果研究[J];中華神經(jīng)外科疾病研究雜志;2010年04期

4 史保中;程小兵;孟秀芝;郭孝龍;郝曉偉;范波;趙勇剛;;頑固性癲癇致癇灶的綜合定位和外科治療[J];陜西醫(yī)學(xué)雜志;2007年01期

5 楊春清;李哲;李攀;李文玲;崔雪花;杜亞麗;;左乙拉西坦治療新診斷癲vN120例[J];醫(yī)藥導(dǎo)報(bào);2012年08期

本文編號(hào)：1788929