NEJM:左乙拉西坦、磷苯妥英和2-丙基戊酸钠治疗难治性持续癫痫

2019-12-03 MedSci MedSci原创

研究认为,左乙拉西坦、磷苯妥英和2-丙基戊酸钠对50%的苯二氮卓类难治性持续癫痫有效,3种药物安全性相当。

苯二氮卓类药物治疗效果不佳的难治性持续癫痫的治疗手段十分有限。

近日研究人员开展一项随机、双盲、适应性试验,比较了三种静脉注射抗惊厥药物(左乙拉西坦、磷苯妥英和2-丙基戊酸钠)对苯二氮卓类治疗无效的儿童和成人惊厥性癫痫持续状态的疗效和安全性。研究的主要结果是输注药物后60分钟内,无临床明显的癫痫发作、意识水平的改善以及无额外的抗惊厥药物。

384名患者参与研究,随机接受左乙拉西坦(145名患者)、磷苯妥英(118名患者)或2-丙基戊酸钠(121名患者)。研究发现,68名左乙拉西坦组患者(47%),53名磷苯妥英组患者(45%)以及56名2-丙基戊酸钠组患者(46%),在60分钟内癫痫持续状态停止和意识水平改善的。每种药物的有效率分别为0.41、0.24和0.35。不良事件方面磷苯妥英组发生低血压和插管次数更多,左乙拉西坦组死亡人数高于其他组,但差异并不显著。

研究认为,左乙拉西坦、磷苯妥英和2-丙基戊酸钠对50%的苯二氮卓类难治性持续癫痫有效,3种药物安全性相当。

原始出处:

Jaideep Kapur et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. N Engl J Med, November 28, 2019.

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    2019-12-05 freve
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    2019-12-03 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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