摘要
目的 采用左乙拉西坦（LEV）预防儿童热性惊厥（FS）的复发，并随访观察其疗效和安全性。方法 将2011年8月至11月在江西省儿童医院住院或门诊就诊的63例反复 FS患儿按先后顺序分为对照组、低剂量组和高剂量组，其中对照组患儿体温在38.5 ℃ 以上时给予退热治疗；高、低剂量组在对照组的基础上，当患儿开始发热时分别口服LEV每次30 mg/kg和15 mg/kg，每日2次，维持1周，然后减量，第8-12天减为每次20 mg/kg和10 mg/kg，每日2次，第13-15天继续减为每次10 mg/kg和5 mg/kg，每日2次，第16天停药。3组均随访观察1年，每3个月随访1次，随访内容包括发热次数、惊厥复发次数、用药情况及药物不良反应。结果 3组复发例数分别为11例、4例、3例，复发率分别为52.38% 、19.05% 、14.29% ，平均复发次数分别为（0.76±1.00）次、（0.19±0.40）次、（0.14±0.36）次；对照组复发次数显著高于治疗组（P 〈0.05），但低剂量组与高剂量组间差异无统计学意义（P =0.951）。低剂量组2例 FS患儿出现轻度嗜睡症状，高剂量组1例 FS患儿出现轻度兴奋、冲动及暴躁等症状。不良反应发生率分别为9.52%（2/21例）和4.76%（1/21例），且2组间比较差异无统计学意义（P =1.000）。结论 LEV 可有效预防反复FS的患儿复发，且小剂量即可达到大剂量相似的预防效果，同时具有不良反应少，耐受性良好等特点。
Objective To evaluate the clinical efficacy and safety of Levetiracetam （LEV） for prophylaxis of febrile seizures （FS） recurrence in children and provide a new approach to treatment. Methods Approved by their guardians ,63 cases were collected from the inpatients or outpatients in Jiangxi Children＇s Hospital from Aug. to Nov. 2011. They were randomly divided into a control group,low dose LEV group and high dose LEV group. When they had a fever of 38.5℃ or higher, only antipyretic was given in the control group. However, LEV was given to the other 2 groups additionally and dosages were ： high dose group, D1 - D7 （ 30 mg/kg ） , D8 - D12 （ 20 mg/kg ）, D13 - D15 （ 10 mg/kg） ,twice a day;low dose group, D1 - D7 （ 15 mg/kg）, D8 - D12 （ 10 mg/kg）, D13 - D15 （ 5 mg/kg）, twice a day. All patients were followed-up every 3 months for 1 year,recording the frequency of fever and seizures recurrence, medication compliance and side effects. Results Eleven cases,4 cases and 3 cases experienced FS recurrences in the control group,the low dose group and high dose group, respectively, and the recurrence rates were 52.38% , 19.05% and 14.29% ,respectively. The average episodes of FS recurrence were （0.76 ± 1.00） times, （0.19 ±0.40） times and （0.14 ± 0.36） times per year among 3 groups, respectively. The recurrence rate of FS in control group was higher than that in treatment groups（ P 〈 0.05 ） ,but there was no significant difference between 2 treatment groups（ P = 0. 951）. Two cases who had mild somnolence in low dose group and only 1 case had mild excitement,impulse and bad-tempered slightly in high dose group. The rates of side effects were 9.52% （2/21 cases）and 4.76% （1/21 case） , and there was no significant difference between them（ P = 1. 000）. Conclusions LEV can effectively prevent the recurrence of FS in children ,and the efficacy of the low dose group is similar to that of the high dose group. Compared with the high dose group, there are less side
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第23期1828-1830,共3页
Chinese Journal of Applied Clinical Pediatrics
关键词
热性惊厥
复发
左乙拉西坦
预防
Febrile seizures
Recurrence
I,evetiracetam
Prevention
