摘要
目的:观察托吡酯对儿童抽动障碍的治疗作用及对患儿血浆谷氨酸(Glu)和门冬氨酸(Asp)水平的影响。方法:选取抽动障碍患儿70例,采用随机数字表分为治疗组和对照组各35例。治疗组给予托吡酯,剂量从0.5 mg/(kg.d)开始,逐渐加量,最大剂量5 mg/(kg.d),对照组给予氟哌啶醇,剂量从1.0 mg/d开始,逐渐加量,最大剂量6.0 mg/d,两组均连用12周。检测两组患儿治疗前和治疗12周后的血浆Glu、Asp水平,观察治疗效果及不良反应。结果:治疗12周后,两组患儿血浆Glu、Asp水平均较治疗前下降(P<0.01或P<0.05),治疗组下降幅度比对照组大(P<0.05);同时两组患儿的运动性抽动分数、发声性抽动分数、综合损害分数和严重度总分均较前明显下降(P<0.05或P<0.01),且治疗组下降的幅度比对照组大(P<0.05);治疗组总有效率为91.43%,高于对照组的71.43%(χ2=4.63,P<0.05);治疗组不良反应发生率为25.71%(9/35)明显低于对照组的57.14%(20/35)(χ2=7.12,P<0.01)。结论:托吡酯治疗儿童抽动障碍的疗效确切,安全性较高,其作用机制可能与降低患儿血浆神经兴奋性氨基酸(Glu、Asp)水平有关。
Objective： To research the effect of topiramate in children with tic disorder and on plasma levels of glutamate and aspartate.Methods： Seventy cases of children with tic disorder were divided into two groups.The treatment group was given topiramate 0.5 mg/（kg·d）at the beginning.Then the dosage was gradually increased,the maximum dose was 5 mg/（kg·d）.Haloperidol was given to the control group,with 1.0 mg/（kg·d） at the beginning.Then the dosage was gradually increased and not more than 6.0 mg/（kg·d）.The treatment course was twelve weeks for the two groups.The results of plasma levels of glutamate and aspartate before and after treatment,curative effect and adverse reactions were observed and compared.Results： After treatment for twelve weeks,plasma levels of glutamate and aspartate in the two groups were decreased dramatically（P0.05 or P0.01）,and the decline in the treatment group was much greater than that in the control group（P0.05）.Motor tic scores,vocal tic scores,comprehensive damage scores and severity scores in the two groups were obviously decreased（P0.05 or P0.01）;the decrease in the treatment group was greater than that in the control group（P0.05）.The total effective rate in the treatment group was higher than that in the control group（χ2=4.63,P0.05）,and the incidence rate of adverse reactions in the treatment group was much lower than that in the control group（χ2=7.12,P0.01）.Conclusions： Topiramate has reliable effect and high safety in children with tic disorder,and the mechanism of action is to decrease the plasma levels of neural excitatory amino acid.
出处
《儿科药学杂志》
CAS
2013年第6期21-23,共3页
Journal of Pediatric Pharmacy
