左乙拉西坦和奥卡西平治疗伴中央颞区棘波儿童良性癫痫的对比研究

Comparative Study in Treatment of Benign Childhood Epilepsy with Centrotemporal Spikes by Levetiracetam and Oxcarbazepine

摘要: 目的：为明确左乙拉西坦(Levetiracetam, LEV)单药治疗首发伴中央颞区儿童良性癫痫(benign child-hood epilepsy with centro-temporal spikes, BECT)患儿的疗效及对认知的影响，采用奥卡西平(Oxcar- bazepine, OXC)作为对照进行开放性、平行性研究。方法：在来我院门诊就诊符合BECT诊断标准的患儿中选取104例，随机分为2组。OXC组51例，LEV组53例。以实验前3个月的每月平均发作次数为基线发作水平，每2~4周电话或门诊回访，记录临床发作次数。服药前、服药后3个月、6个月、12个月进行认知功能评定(4~6岁采用韦氏学龄前及小学智力量表，6~16岁采用韦氏儿童智力量表)。结果：1) 疗效比较：3次回访二组有效率、各组组内不同回访时间有效率比较无差异。2) 认知功能比较：基线时及12个月治疗后两组儿童比较无统计学差异。两组患儿用药后自身对照比较均显示多项分测验得分有增高趋势，OXC组治疗前后得分改变无统计学意义，LEV组的词汇及数字广度分测验得分的提高幅度与治疗前相比有统计学意义。结论：首选LEV治疗儿童BECT疗效与OXC相似，对BECT患儿的认知无不良影响。

Abstract: Objective: To clarify the therapeutic effect and the cognitive improvement of Levetiracetam (LEV) monotherapy on the first BECT (benign childhood epilepsy with centro-temporal spikes, BECT) compared with Oxcarbazepine (OXC) in an open and parallel study. Methods: 104 patients who were admitted in our hospital and conformed to the BECT diagnostic criteria were divided into two groups randomly: OXC therapy group (51 cases) and LEV therapy group (53 cases). The monthly average seizure times of the 3 months before the beginning of the study were taken as the baseline seizure level, while the seizures times were recorded after telephone follow-up or clinical return visits per 2 - 4 weeks. Evaluations on cognitive functions were conducted before the treatment and 3 months, 6 months and 12 months after the treatment (Wechslet preschool and primary scale of intelligence were applied to the patients at the age of 4 - 6, and Wechsler intelligence scale for children were applied to those at the age of 6 - 16). Results: 1) Comparison of curative effects: The curative effect difference between the LEV group and OXC group and the difference during the different period of each group were both not significant. 2) Comparison of cognitive function: There is no statistical difference between the two groups before and after treatment. Both the two groups showed an increasing trend of intelligence test scores after treatment. There was no statistical significance between scores before and after OXC treatment, while the scores difference of words and digit span before and after the treatment of LEV had statistical significance. Conclusions: The curative effect of LEV on the first BECT patients is similar to OXC without adverse influence on cognition.