341 例癫痫患儿用药特点分析

目的：探讨癫痫患儿临床用药特点，为临床合理应用抗癫痫药物提供参考。方法：回顾性分析2018年2月至2018年8月西北妇女儿童医院和西安交通大学第二附附属医院收治的341例癫痫患儿临床资料，对其用药方案选择及发作控制率进行统计分析。结果：341例癫痫患儿中，男女比例1.04∶1，年龄9个月~19岁，其中1~3岁患儿占比最大，为32.55%。经抗癫痫药物治疗，341例患儿Ⅲ级以上总体发作控制率为84.45%。单药治疗、双药治疗和三种及以上联合治疗Ⅱ级以上控制率分别为94.45%、69.63%和45.56%。单药治疗中使用率前3位的药物分别为左乙拉西坦、苯巴比妥和卡马西平；多药治疗中使用率前3位的药物分别为左乙拉西坦、丙戊酸钠和托吡酯。单药治疗以左乙拉西坦为主，联合治疗主要以左乙拉西坦＋丙戊酸钠或托吡酯为主。结论：儿童癫痫发病以婴幼儿期最多，药物治疗总体控制率较高，新型抗癫痫药和传统抗癫痫药在治疗选择中使用率相当，新型抗癫痫药物左乙拉西坦在各发作类型及各种治疗方案中使用率最高。治疗药物选择主要为左乙拉西坦、苯巴比妥和卡马西平，抗癫痫药物联合治疗方案主要为丙戊酸钠+左乙拉西坦和丙戊酸钠+氯硝西泮+左乙拉西坦。

Analysis of Medication Characteristics in 341 Children with Epilepsy

Objective: To investigate the use of antiepileptic drugs in children with epilepsy,and to provide reference for clinical medication. Methods: The clinical data of 341 children who were admitted to the outpatient clinic of pediatric epilepsy specialty in two hospitals from February 2018 to August 2018 were reviewed, and the drug regimen selection and seizure control rate were statistically analyzed. Results: In 341 epilepsy patients investigated, the ratio of male to female was 1.04:1. The age of the patients ranged from 9 months old to 19 years old, and the median age was 6.75 years, and 32.55% of the patients were aged from 1 to 3 years. The treatment rates of single drug, double drug, three or more antiepileptic drugs were respectively 47.5%, 29.6% and 22.9%. The overall seizure control rate of 341 patients above Grade II was 84.45% after treatment with antiepileptic drugs,. The control rates were 94.45%, 69.63% and 45.56% in single drug treatment, double drug treatment and three or more combination treatment. The top three drugs used in single drug therapy were levetiracetam (LEV), phenobarbital (PB) and carbamazepine (CBZ) , and the top three drugs used in multidrug therapy were LEV, VPA and TPM. Conclusion: The incidence of epilepsy in children is the most in infancy; Drug therapy was mainly single drug therapy, followed by dual drug combination therapy. LEV, Phenobarbital, CBZ, LEV, VPA and TPM are all first-line drugs for drug therapy, with high frequency of use. The most common two-drug combination regimens are LEV with VPA, LEV with TPM, or LEV with CZP.