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目的 分析癫疒间 患儿服用托吡酯 (TPM )后发生类暑热症的临床特征、处理及随访结果。方法 对1999年 5月至 2 0 0 3年 10月在西安交通大学第二医院接受TPM治疗的 338例癫疒间 患儿中发生类暑热症不良反应的病例进行分析。结果 338例癫疒间 患儿中 4 2例 (12 4 % )出现类暑热症症状 ,年龄为 8个月至 9岁 ,主要表现为少汗或无汗 ,皮肤干燥或发红 ,活动后加重 ,体温正常者 8例 ,31例伴低热 ,3例中度发热 ,2例伴尿频。 33例类暑热症发生于夏季 ,9例出现于冬春季节。每日所服TPM剂量 <3mg/kg 6例 ,3 0～ 4 9mg/kg 2 3例 ,≥ 5mg/kg 13例。经降低环境温度及 (或 )适当减少TPM剂量处理后大多数患儿类暑热症状减轻 ,10例停药。连续服TPM两年以上的 18例患儿中 15例次年相同季节类暑热症状再发 ,3例消失。结论 类暑热症是夏季服用TPM癫疒间 患儿较为常见的一种不良反应 ,应当注意识别 ,以免误诊误治
Objective To analyze the clinical features, treatment and follow-up of sunstroke-like fever patients after taking topiramate (TPM) in children with epilepsy. Methods From May 1999 to October 2003 in the Second Hospital of Xi’an Jiaotong University, TPM treatment of 338 cases of children with epilepsy-like fever cases of adverse reactions were analyzed. Results Of the 338 children with epilepsy, 42 cases (124%) had symptoms of summer fever, ranging from 8 months to 9 years old. The main symptoms were little or no sweat, dry or red skin, aggravated after exercise , Normal body temperature in 8 cases, 31 cases with fever, 3 cases of moderate fever, 2 cases with frequent urination. 33 cases of summer fever occurred in summer, 9 cases occurred in winter and spring. TPM daily dose of <3mg / kg in 6 cases, 30 ~ 49mg / kg 23 cases, ≥ 5mg / kg in 13 cases. After reducing the ambient temperature and (or) the appropriate reduction in TPM dose treatment of children with symptoms of heat relief, 10 cases discontinued. Fifteen of the 18 children with continuous TPM more than two years had recurrent symptoms of summer heat in the same year of the following year, and 3 disappeared. Conclusion Summer heat syndrome is more common in children with TPM epilepsy taking summer adverse reactions, should pay attention to identify, so as to avoid misdiagnosis and mistreatment