【摘要】 目的　观察托吡酯 (TPM )添加治疗儿童癫疒间 的疗效。方法　采用不同剂量 (3 2～ 12 0mg·kg-1·d-1)的托吡酯添加治疗 35例儿童部分性和 (或 )全身性癫疒间(基线发作次数的中位值 6次 /月 )的开放性研究。TPM治疗的平均时间为 (44 7± 14 2 )d (范围 2 8～ 5 82d) ,TPM持续治疗 3个月和 6个月的平均剂量为 6 75mg·kg-1·d-1。结果　 >70 %的患儿发作频率减少≥ 5 0 % ,38% (13/34)的患儿无发作持续 3个月以上 ,4 3%(14 /32 )的患儿无发作持续 6个月以上。接受不同剂量TPM的治疗反应大致相同 (P >0 0 5 )。而最常见的不良反应为中枢神经系统的表现。经过 1 5年的治疗 ,2 6 %的患儿因不良反应和发作未得到适当的控制而未继续用药。结论　TPM添加治疗儿童癫疒间具有良好的耐受性和安全性 ,并可作为基础抗癫疒间 药物失败后长期控制癫疒间 发作的广谱抗癫疒间药。更多还原

【Abstract】 Objective To study the effects of topiramate (TPM) as an adjuvant therapy in children epilepsy.Methods A total of 35 children with partial and/or generalized seizures previously resistant to antiepileptic drug (AED) therapy were treated with open-label TPM at dosages of 3.2～12.0mg/(kg·d).The mean duration of TPM treatment was (447±142)days (range:28～582 days) and the mean TPM dosage was 6.75mg/(kg·d)(range:3.2～14.0mg/(kg·d).Seizure reduction was calculated from seizure counts during the last 3 months and last 6 months of TPM therapy compared with baseline.Results Over 70% of patients achieved ≥50% seizure reduction;13 patients (38%) were seizure free for≥3months at the last visit;43% patients were seizure free for ≥6months at the last visit.This therapeutic response was consistent for children receiving TPM dosages <4mg/(kg·d),4～8mg/(kg·d) and >8mg/(kg·d).The most commonly reported adverse reactions were related to the central nervous system.Over a year and a half treatment period,26% children discontinued TPM therapy due to adverse effects and inadequate seizure control.Conclusion TPM as adjuvant therapy is well tolerated and safe.It is a useful AED for long-term seizure control after failure in previous AED therapy.更多还原