托吡酯治疗小儿癫痫的近期疗效及随访观察

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目的探讨托吡酯治疗小儿癫痫的效果观察。方法小儿癫痫患者120例,随机分为观察组与对照组,各60例,对照组给予丙戊酸钠治疗,初始剂量为5~15 mg/(kg·d),逐渐增加并维持至15~30 mg/(kg·d),1次/d,疗程为3~6个月;观察组给予托吡酯治疗,初始剂量为0.5~1.0 mg/(kg·d),逐渐增加并维持至4~8 mg/(kg·d),2次/d,疗程为3~6个月。比较两组临床疗效和不良反应发生率。对患儿进行为期6个月的随访观察,应用韦氏儿童智力量表检测认知功能(IQ)。采用方差分析及χ2检验进行统计学处理。结果观察组总有效率为93.33%,对照组为78.33%,差异有统计学意义(P<0.05);观察组不良反应总发生率为10.00%,对照组为26.67%,差异有统计学意义(P<0.05)。观察组IQ评分治疗1个月时较治疗前显著较低,治疗6个月时较治疗1个月时升高(均P<0.05);治疗1个月时观察组IQ评分较对照组降低(P<0.05)。结论托吡酯治疗小儿癫痫有效率高,不良反应发生率低。 Objective To investigate the effect of topiramate on children with epilepsy. Methods A total of 120 children with epilepsy were randomly divided into observation group and control group, 60 cases in each group. The control group was treated with sodium valproate, the initial dose was 5 ~ 15 mg / (kg · d), gradually increased and maintained until 15 ~ 30 mg / (kg · d) once a day for 3 to 6 months. Patients in the observation group were given topiramate at initial dose of 0.5-1.0 mg / (kg · d) and gradually increased to 4-8 mg / (kg · d), 2 times / d, course of treatment is 3 to 6 months. The clinical efficacy and incidence of adverse reactions in both groups were compared. Children were followed up for 6 months, and Wechsler Children’s Intelligence Scale was used to detect cognitive function (IQ). ANOVA and χ2 test were used for statistical analysis. Results The total effective rate was 93.33% in the observation group and 78.33% in the control group (P <0.05). The total incidence of adverse reactions in the observation group was 10.00% and in the control group was 26.67%, the difference was statistically significant (P < P <0.05). The score of IQ in observation group was significantly lower than that before treatment at 1 month and 6 months after treatment (all P <0.05). IQ score of observation group was lower than that of control group at 1 month P <0.05). Conclusion Topiramate treatment of epilepsy in children with high efficiency, low incidence of adverse reactions.
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