【摘要】 目的探讨托吡酯(TPM)与左乙拉西坦(LEV)联合丙戊酸钠(VPA)治疗婴儿痉挛症(IS)的临床疗效,为优化药物治疗提供临床依据。方法选择本院2011年8月至2014年6月的IS患儿38例,按随机数字表法分为TPM组(VPA联合TPM治疗)和LEV组(VPA联合LEV治疗),每组19例,观察两组患儿痉挛发作次数、不良反应,并用Gesell发育量表评估发育商(DQ)值。结果 3个月后,TPM组控制痉挛发作的总有效率为84.21%,LEV组为78.95%,两组比较差异无统计学意义(P>0.05)。TPM组患儿共5例出现轻度不良反应,LEV组4例出现轻度不良反应。TPM组DQ值与治疗前比较差异无统计学意义(P>0.05);LEV组患儿的DQ值较治疗前明显提高,差异有统计学意义(P<0.05),与TPM组治疗后比较,差异有统计学意义(P<0.05)。结论 TPM与LEV治疗IS对控制痉挛发作疗效相同,但LEV治疗能明显提高IS患儿的智能发育,总体疗效优于TPM。更多还原

【Abstract】 Objective To investigate the clinical effects of topiramate(TPM)or levetiracetam(LEV)combined with sodium valproate in the treatment of infantile spasms(IS)to provide the clinical basis for optimizing the medication therapy.Methods 38 children patients with IS diagnosed in our hospital from August 2011 to June 2014 were selected and divided into the TPM group(VPA combined with TPM)and the LEV group(VPA combined with LEV)according to the random number table method,19 cases in each group.The frequency of spasm onset and adverse reactions were observed in the two groups and the development quotient(DQ)was evaluated by using the Gesell development scale.Results After 3months,the total effective rate of the TPM group for controlling the spasm onset was 84.21% and which in the LEV group was 78.95%,there was no statistically significant difference between the two groups(P>0.05).5cases in the TPM group and 4cases in the LEV group appeared mild adverse reactions.The DQ value in the TPM group had no statistically significant differences between before and after treatment(P>0.05),while the DQ value after treatment in the LEV group was significantly increased,which had the statistically significant difference between before and after treatment in the LEV group and between the two groups after treatment(P<0.05).Conclusion TPM and LEV have the same effect in controlling spasm onset.But LEV can significantly enhance the intelligence development of children with IS and superior to TPM in the total effect.更多还原