【摘要】 目的观察拉莫三嗪添加-替换治疗丙戊酸治疗无效的癫痫患者的临床疗效。方法对丙戊酸治疗无效的78例癫痫患者加用拉莫三嗪,并逐渐转为拉莫三嗪单药治疗。观察联合用药阶段及拉莫三嗪单药治疗阶段结束时的癫痫发作控制情况、拉莫三嗪血药浓度变化及不良反应。结果 64例患者完成联合治疗阶段,其中完全控制46例(71.9%),有效10例(15.6%),无效8例(12.5%);总有效率为87.5%。42例患者转为拉莫三嗪单药治疗,其中控制31例(73.8%),有效4例(9.5%),无效7例(16.7%);总有效率为83.3%。拉莫三嗪单药治疗与联合用药阶段的完全控制率、总有效率比较,差异无统计学意义(均P>0.05)。联合用药阶段患者的拉莫三嗪血药浓度显著高于拉莫三嗪单药治疗阶段(P<0.01)。拉莫三嗪单药治疗阶段再发患者的拉莫三嗪血药浓度与控制患者的差异无统计学意义。18例患者出现不良反应。结论拉莫三嗪单用或联合丙戊酸治疗丙戊酸治疗无效的癫痫患者效果较好,不良反应少。更多还原

【Abstract】 Objective To observe the therapeutic effect of lamotrigine( LTG) adding-replacement on ineffective valproate treatment of epilepsy patients. Methods LTG was used on 78 patients who had ineffective treatment of epilepsy with valproate,and turned to LTG single therapy gradually. To observed the epileptic seizure, blood concentration of LTG and adverse reactions at the end of combination therapy stage and LTG single therapy stage. Results Sixty-four patients completed the combination therapy stage,completely controlled was in 46 cases( 71. 9%),effective was in 10 cases( 15.6%),ineffective was in 8 cases( 12. 5%). The total effective rate was 87. 5%. Forty-two patients were converted to single therapy of LTG,completely controlled was in 31 cases( 73. 8%),effective was in 4 cases( 9. 5%),ineffective was in 7 cases( 16. 7%). The total effective rate was 83. 3%. There was no statistical significance of completely controlled rate and total effective rate between combination therapy stage and LTG single therapy stage( all P > 0. 05). The blood concentration of LTG in combination therapy stage was significantly higher than that in LTG single therapy stage( P < 0. 01). There was no statistical significance in blood concentration of LTG between patients with recurrent seizures and seizures controlled in LTG single therapy stage. Eighteen patients had adverse reaction. Conclusion LTG adding-replacement valproate has good effect on ineffective valproate treatment of epilepsy patients,and with less adverse reaction.更多还原