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目的 观察托吡酯 (TPM )添加治疗儿童癫疒间 的疗效。方法 采用不同剂量 (3 2～ 12 0mg·kg-1·d-1)的托吡酯添加治疗 35例儿童部分性和 (或 )全身性癫疒间(基线发作次数的中位值 6次 /月 )的开放性研究。TPM治疗的平均时间为 (44 7± 14 2 )d (范围 2 8～ 5 82d) ,TPM持续治疗 3个月和 6个月的平均剂量为 6 75mg·kg-1·d-1。结果 >70 %的患儿发作频率减少≥ 5 0 % ,38% (13/34)的患儿无发作持续 3个月以上 ,4 3%(14 /32 )的患儿无发作持续 6个月以上。接受不同剂量TPM的治疗反应大致相同 (P >0 0 5 )。而最常见的不良反应为中枢神经系统的表现。经过 1 5年的治疗 ,2 6 %的患儿因不良反应和发作未得到适当的控制而未继续用药。结论 TPM添加治疗儿童癫疒间具有良好的耐受性和安全性 ,并可作为基础抗癫疒间 药物失败后长期控制癫疒间 发作的广谱抗癫疒间药。
Objective To observe the efficacy of topiramate (TPM) in children with epilepsy. Methods A total of 35 children with partial and / or generalized epilepsy (median 6 times / month) were treated with topiramate (32 to 120 mg · kg -1 · d -1) Open study. The average duration of TPM treatment was (44 7 ± 14 2) days (range 28-582 days). The mean dose of TPM for 3 months and 6 months was 6 75 mg · kg -1 · d -1. RESULTS: Seventy percent of children had a> 50% reduction in seizure frequency, 38% (13/34) had no episode for more than 3 months, and 43% (14 of 32) had no seizure lasting 6 months the above. The response to treatment with different doses of TPM was approximately the same (P> 0.05). The most common adverse reaction is the performance of the central nervous system. After 15 years of treatment, 26% of the children did not receive medication due to adverse reactions and seizures without adequate control. Conclusion TPM has good tolerance and safety in the treatment of children with epilepsy, and can be used as a broad-spectrum antiepileptic drug for long-term control of epileptic seizures after failed antiepileptic drugs.