【摘要】 目的 探讨新诊断癫痫患者抗癫痫药物(AEDs)早期药物治疗反应对长期结局的预测价值及其临床影响因素。方法收集在我科治疗的164例新诊断癫痫患者,根据是否在6个月内获得发作缓解将其分为早期发作缓解组(ESR组)与早期发作未缓解组(非ESR组),比较两组患者2年、3年发作缓解率的差异,分析治疗前发作次数、性别、发病年龄、癫痫类型、治疗前病程、脑电图、颅脑影像学等临床因素对早期药物治疗反应的影响。结果164例患者中ESR组106例(64.63%),非ESR组58例(35.37%)。随访结束时,ESR组中2年发作缓解率为94.34%(100/106)、3年发作缓解率为90.57%(96/106);非ESR组中2年发作缓解率为65.52%(38/58)、3年发作缓解率为56.90%(33/58)。ESR组患者2年和3年发作缓解率均明显高于非ESR组(P<0.001)。单因素分析结果显示,治疗前癫痫多次发作是影响早期发作缓解的重要危险因素(P<0.001),而患者性别、发病年龄、癫痫类型、治疗前病程、脑电图、颅脑影像学与早期药物反应无明显相关性。结论新诊断癫痫患者早期药物治疗有效提示长期预后良好,治疗前发作次数是影响新诊断癫痫患者早期发作缓解的重要因素。更多还原

【Abstract】 Objective To explore the value of early response of antiepileptic epilepsy drugs(AEDs) to predict long-term outcome in newly diagnosed epilepsy patients and analyze the clinical factors which effected the early response to AEDs. Methods A total of 164 newly diagnosed epilepsy patients in our hospital were collected. All patients were divided into early seizure remission group(ESR group) and non-ESR group according to whether they had achieved seizure remission within 6 months. The 2-year seizure remission(2 YSR) and 3-year seizure remission(3 YSR) rate between two group were compared.The clinical influencial factors of early response to AEDs such as the number of seizures before treatment,sex,the age at seizure onset, epilepsy type, pretreatment duration, electroencephalogram( EEG) record at diagnosed and craniocerebral imaging were analyzed. Results There were 106 patients(64. 63%) in ESR group and 58 patients(35. 37%) in non-ESR group. In ESR group,the 2 YSR and 3 YSR rate were94.34%(100/106) and 90. 57%(96/106) respectively. In non-ESR group, the 2 YSR and 3 YSR rate were 65. 52%(38/58) and 56. 90%(33/58) respectively. The rates of 2 YSR and 3 YSR were significant higher in ESR group than those in non-ESR(P < 0. 001). Univariate analysis showed multiple seizures before treatment affected the early seizure remission(P <0. 001),but the factors including sex,the age at seizure onset, epilepsy type, pretreatment duration, EEG record at diagnosed and craniocerebral imaging were not significantly associated with the early response of AEDs. Conclusion The early response of AEDs is significantly associated with long-term outcome in patients with newly diagnosed epilepsy and the number of seizures before treatment is the main clinical factor that effect the early seizure remission.更多还原