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目的评价左乙拉西坦(LEV)单药治疗小儿癫癎的疗效和安全性。方法收集2007年8月-2009年8月武汉市儿童医院神经内科门诊新诊断的41例癫癎患儿(男26例,女15例;年龄7个月～13岁),均采用LEV单药治疗。LEV的起始剂量为(13.6±4.7)mg·kg-1·d-1,2次.d-1,目标剂量为(25.7±7.5)mg·kg-1·d-1,2次·d-1。进行开放性自身对照随访观察,随访时间为6个月～2a。结果 LEV单药治疗癫癎患儿的有效率为68.3%(28例),其中完全控制率为39.0%(16例)。无效者占31.7%(13例),其中7例(17.1%)因治疗无效或发作加重而停止LEV治疗。不良反应的发生率为36.6%(15例),主要包括胃肠不适(5例)、易激惹(5例)、头晕(2例)、嗜睡(2例)等,发生于用药初期2～4周,多在发生1周～1个月自然消失。结论 LEV单药治疗癫癎患儿局灶性发作及全面性发作的疗效是肯定的,安全性好,可以作为小儿癫癎治疗的一线广谱抗癫癎药。
Objective To evaluate the efficacy and safety of levetiracetam (LEV) monotherapy in children with epilepsy. Methods A total of 41 newly diagnosed epilepsy children (26 males and 15 females; aged 7 months to 13 years old) were collected from Department of Neurology, Wuhan Children’s Hospital from August 2007 to August 2009. All patients were treated with LEV monotherapy treatment. The initial dose of LEV was (13.6 ± 4.7) mg · kg-1 · d-1, and the target dose was (25.7 ± 7.5) mg · kg-1 · d-1, -1. Followed by open self-control follow-up observation, follow-up time was 6 months ~ 2a. Results The effective rate of LEV monotherapy in children with epilepsy was 68.3% (28 cases), of which the complete control rate was 39.0% (16 cases). Invalidation accounted for 31.7% (13 cases), of which 7 (17.1%) discontinued due to ineffective treatment or exacerbations of LEV treatment. The incidence of adverse reactions was 36.6% (15 cases), including gastrointestinal discomfort (5 cases), irritability (5 cases), dizziness (2 cases), drowsiness (2 cases) 4 weeks, more in the occurrence of 1 week ~ 1 month naturally disappear. Conclusion LEV monotherapy in children with focal seizures and comprehensive treatment of seizures is positive, good security, pediatric epilepsy can be used as a broad-spectrum anti-epileptic drugs.