拉莫三嗪和丙戊酸钠联合治疗儿童难治性癫痫临床讨论【摘要】 目的：了解丙戊酸钠和拉莫三嗪治疗儿童难治性癫痫的疗效。方法：收集儿童难治性癫痫 21 例，已在使用 VPA且血药浓度在有效范围内者，即从 mg/(kg·d)、1 次/d 开始加 LTG，第 1 个月每周增加 mg/(kg·d)，第 2 个月每周增加 mg/(kg·d)，以后每周增加～1 mg/(kg·d)，直至发作控制或剂量达 10 mg/(kg·d)。未使用 VPA 者，从 20 mg/(kg·d)开始加 VPA，并调整血药浓度至50～100 μg/mL，再逐渐减停其它抗癫痫药物，加 LTG，方法同上。随访发作情况，监测不良反应。结果：治疗 9 个月时 10 例完全控制，5 例有效，6 例无效，治疗后发作频率减少，差异有统计学意义，5 例脑电图恢复正常，8 例出现不良反应。结论：LTG 和 VPA 联用为一种有效、安全而经济的治疗小儿难治性癫痫的方法。【关键词】 拉莫三嗪 丙戊酸钠 难治性癫痫 儿童 自身对比 ［Abstract］ Objective:To study the effect in children with intractable epilepsy who were treated with combination of valproic acid sodiumand :Lamotrigine of mg/(kg·d) was added to the patients with normal serum level at 50～100 μg/mL who were already treated with VPA, the dosage being increased by mg/(kg·d) per week in the first month, mg/(kg·d) per week in the second month and then ～1 mg/(kg·d) per week till free from the seizure or up to 10 mg/(kg·d). The patients not treated with VPA were added with VPA untill a valid serum concentration was reached and then dosages of other antiepilepsic drugs were cut down till stopped in use, meanwhile lamotrigine was applied in the same ways mentioned above. The episodes of seizures and side effects were :After 9 months of treatment, seizures of 10 patients (%) were under control, 5 patients (%) had an effective reduction in numbers of seizures, but the treatment was ineffective in 6 patients (%). The difference in the number of seizures before and after treatment was significant...
