左乙拉西坦治疗小儿癫痫的影响分析

目的研究左乙拉西坦治疗小儿癫痫的疗效以及对智力的影响。方法在本院2017年4月-2019年5月收治的小儿癫痫患儿中选取74例开展研究,按照随机数表法分两组观察组和对照组,观察组37例,对照组37例,对照组采用奥卡西平进行治疗,观察组采用左乙拉西坦进行治疗,对比观察组与对照组组的治疗总有效率和智力评分变化。结果观察组与对照组比较,观察组的治疗总有效率较高,智力评分明显较高,两项对比差异有统计学意义(P <0.05)。结论左乙拉西坦治疗小儿癫痫有较好的治疗效果,治疗总有效率较高,且对患儿的智力有明显的改善作用,在实际临床小儿癫痫的治疗中具有较高的运用价值。     

Pilot efficacy and tolerability: a randomized, placebo-controlled trial of levetiracetam for essential tremor.

The purpose of this pilot single-site study was to assess efficacy and safety of levetiracetam for essential tremor, using a placebo-controlled, double-blind, randomized crossover design with an interim analysis planned after completion of the first 10 to 15 subjects. The study was designed to detect a mean 30% reduction in composite tremor score, comparable to that of primidone or propranolol, which can be demonstrated with 30 or fewer subjects. Each treatment arm included baseline tremor assessments, a 4-week medication titration, 2 weeks of stable dose, and treatment tremor assessments. Levetiracetam was titrated to 3,000 mg/day or to a lower maximal tolerated dose. The median age was 72 years, with 28 years median tremor duration. There was no statistically significant difference in response between placebo and levetiracetam on any tremor rating scale or accelerometry measure. The 95% confidence interval for the true mean difference between placebo and levetiracetam treatments was +18.5 to -22.5%, which excludes the minimum 30% drop required to consider levetiracetam clinically effective to a degree comparable to primidone or propranolol. Whether levetiracetam has lesser-degree antitremor efficacy was not addressed in this pilot study.     

Levetiracetam monotherapy in Alzheimer patients with late-onset seizures: a prospective observational study

Levetiracetam (LEV) monotherapy was investigated in 25 patients with advanced Alzheimer's disease (AD) and new-onset epileptic seizures in a prospective open-label study. At a daily dose of 1000–1500 mg, 72% were seizure-free for at least one year; 16% discontinued for untolerability; 8% were unresponsive; 4% were lost to follow-up. These results suggest the need for controlled studies to confirm if LEV can be a first-choice drug in AD.     

The effects of levetiracetam on objective and subjective sleep parameters in healthy volunteers and patients with partial epilepsy

Levetiracetam is a novel antiepileptic drug which has recently been released as an adjunctive treatment for partial epilepsy. In the two studies reported here we examined the objective and subjective effects of levetiracetam on sleep in 12 healthy volunteers and 17 patients [16 who could be evaluated for electroencephalogram (EEG) recordings] with a history of partial epilepsy on stable carbamazepine monotherapy. The studies were of a similar double-blind crossover placebo-controlled design with subjects' sleep being recorded in their own homes. The results from the two studies showed considerable similarities. In both, levetiracetam produced an increase in the time spent in stage 2 sleep, which in the patient study was accompanied by a decrease in the time spent in stage 4 sleep and in the volunteer study an increase in rapid eye movement (REM) latency. The subjective changes included reports that sleep was of a better quality with fewer awakenings and patients also reported that their sleep was more restful. Volunteers and patients did, however, feel less alert on waking in the morning. Therefore, both groups reported a decrease in awakenings after levetiracetam despite the finding from the EEG of no change in the actual number of awakenings. It may be concluded from both studies that levetiracetam does affect some indicators of subjective sleep perception, but does not influence objective sleep measures of sleep continuity. The results from the patient study during placebo add-on treatment also showed that patients on carbamazepine had a marked increase in SWS, an increase in stage 2 sleep and an increase in REM latency compared with healthy volunteers. Interestingly, levetiracetam also reduced bilateral epileptiform EEG activity, particularly in patients with more discharges.     

Evaluation of the relaxant effect of levetiracetam on isolated rat duodenum

Levetiracetam (LEV) is an approved drug for the treatment of some epileptic disorders. With few and controversial reports addressing its possible pharmacodynamic interactions, the current study aimed at studying the effect of LEV on isolated rat duodenal strips to enlighten its possible intestinal adverse effects using the isolated smooth muscle strips of rat duodenum. LEV showed a dose‐dependent inhibition in KCl (80 mm )‐induced contractions in normal Tyrode's solution. Moreover, preincubation with LEV (3 mm ) in K⁺‐rich/Ca²⁺‐free medium led to a significant decrease in the maximum contractions (E_max) coupled to a right shift of the cumulative CaCl₂ concentration curves implying a possible Ca²⁺ channel blocking potential. In addition, LEV exhibited a typical noncompetitive inhibition in the cumulative carbachol concentration curves evidenced as a decrease in E_max without the alteration of EC₅₀, thus eliminating any possible role of the muscarinic receptors in the relaxant effect. To rule out other possible relaxant mechanisms, tests were conveyed in Tyrode's solution containing either 100 μm l ‐NAME or 10 μm glimepiride to test the possible relaxant roles exhibited by nitric oxide (NO) and K_ATP channel opening, respectively. None of the tested pathways was involved in LEV‐mediated relaxation. Taken altogether, the results of the current study entail that LEV might exert a relaxant effect on intestinal smooth muscles through blocking L‐type voltage‐operated calcium channels, but not involving either NO release or K_ATP channel opening.     

左乙拉西坦缓释片在Beagle犬中的生物等效性研究

目的以Beagle犬为模型考察自制左乙拉西坦缓释片与参比缓释片(Keppra XR)在动物体内的生物等效性。方法 Beagle犬分别单剂量口服自制缓释片与参比制剂1 000mg,采用LC-MS/MS方法测定犬血浆中左乙拉西坦的浓度,通过药代动力学计算软件WinNonlin 5.2以非房室模型分别计算左乙拉西坦的药代动力学参数。结果自制缓释片与市售参比缓释片单剂量口服后,左乙拉西坦的达峰时间tmax分为1.67h和3.0h;峰浓度Cmax分别为89.50μg/ml和71.18μg/ml;消除半衰期t1/2分别为3.68h和3.50h;药时曲线下面积AUC(0-48)分别为826.57μg·h/ml和757.84μg·h/ml;药时曲线下面积AUC(0-∞)分别为826.68μg·h/ml和757.93μg·h/ml。与参比缓释片相比,自制左乙拉西坦缓释片的相对生物利用度为109.07%。结论初步判定两种制剂在犬体内具有类似的药代动力学特征和生物等效性。     

左乙拉西坦治疗癫的疗效及安全性分析

目的：观察左乙拉西坦（LEV）单药和（或）添加治疗成人癫?的临床治疗效果及安全性,旨在为今后临床治疗方案的选择提供参考和借鉴。方法：前瞻性选取本院神经内科2010～2013年4年间收治的160例成人癫?患者,根据是否为新确诊患者分为2组：Ⅰ组为既往确诊患者给予LEV添加治疗,Ⅱ组为新诊断癫?患者开始即给予L EV单药治疗,对比两组患者临床疗效及不良反应。结果：Ⅰ组总有效率为85．8％,略低于Ⅱ组的87．5％,但差异无统计学意义（χ2＝0．0703,P＝0．7909）;各型癫?疗效比较差异亦无统计学意义（ P＞0．05）;Ⅰ组脑电图缓解率为48．1％,略低于Ⅱ组的53．3％（χ2＝0．1287,P＝0．7198）,均无1例脑电图加重;Ⅰ组不良反应发生率为29．2％略高于Ⅱ组的27．5％（χ2＝0．0407,P＝0．8402）,副作用均较轻微,未给予处理,于2～5周内缓解或消失。结论：L EV不管是单药还是添加治疗对各型成人癫?具有疗效,能显著改善患者脑电图,不良反应发生率低且症状轻微,持续时间短,患者耐受性好,可作为临床治疗成人癫?的首选药物之一。     

左乙拉西坦对癫痫患儿甲状腺激素及甲状旁腺激素的影响

正癫痫是由多种病因引起,临床表现为脑神经的过度放电,导致中枢神经系统短暂、反复发作性功能紊乱。我国约有900万癫痫患者,患病率4‰~7‰~([1])。约60%的癫痫患者在儿童期起病~([2])。左乙拉西坦(levetiracetam,LEV)是一种新型抗癫痫药物,临床应用日益增多。但目前关于左乙拉西坦对癫痫患儿内分泌激素影响的研究鲜有报道。本研究拟通过检测LEV治疗过程中,癫痫患儿血清甲     

左乙拉西坦治疗原发性癫痫的临床疗效及其对生活质量的影响

目的探讨左乙拉西坦治疗原发性癫痫的临床疗效,及其对生活质量的影响。方法选择符合标准的患者60例,随机分为观察组和对照组各30例,观察组应用左乙拉西坦,对照组应用丙戊酸钠,比较两组临床治疗效果及其生活质量。结果治疗6个月后,观察组患者癫痫发作完全控制率及QOLIE-31评分高于对照组,痫样波放电率低于对照组,差异有统计学意义(P<0.05),两组患者不良反应发生率差异无统计学意义(P>0.05)。结论左乙拉西坦治疗新诊断原发性癫痫,能有效控制癫痫发作和痫样放电,提高患者生活质量,安全性高,值得临床推广应用。