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目的评价左乙拉西坦治疗小儿癫痫的疗效和安全性。方法计算机检索近十年(2001-2011)来PubMed、Cochrane Database of Systematic Reviews、EMbase、中国知网(CNKI)检索平台、万方数据库中纳入左乙拉西坦治疗小儿癫痫的随机对照研究(RCTs),研究者对文献质量进行严格评价和资料提取。对符合质量标准的RCTs用Review manager 5.0软件进行Meta分析。结果 6个RCTs共610名患者纳入研究,其中治疗组(使用左乙拉西坦)333例,对照组(常规治疗)277例。Meta分析结果表明治疗组患者每周癫痫发病率明显低于对照组,对于患者继发嗜睡、头痛等中枢系统不良反应及肝肾功能损害方面,RCTs结果显示无显著差异。结论左乙拉西坦治疗不良反应种类少,对各种发作类型的小儿癫痫均有良好疗效,且不增加发生其他不良结局的危险性,可作为小儿癫痫患者的首选治疗方案之一。
Objective To evaluate the efficacy and safety of levetiracetam in the treatment of children with epilepsy. Methods A randomized controlled study of levetiracetam in the treatment of epilepsy in children was included in the database of PubMed, Cochrane Database of Systematic Reviews, EMbase, CNKI (2001-2011) ), The researchers conducted rigorous evaluation of the quality of the literature and data extraction. RCTs that meet the quality standards were analyzed Meta using Review manager 5.0 software. Results A total of 610 patients with 6 RCTs were enrolled in the study, including 333 in the treatment group (with levetiracetam) and 277 in the control group (conventional treatment). Meta-analysis showed that the incidence of epilepsy was significantly lower in the treatment group than that in the control group. RCTs showed no significant difference in central nervous system adverse reactions and hepatic and renal dysfunction secondary to sleepiness and headache. Conclusions Levetiracetam has few adverse reactions and is effective in treating various types of epilepsy in pediatric epilepsy. It does not increase the risk of other unfavorable outcomes and may be considered as the first choice of treatment for children with epilepsy.