JAMA Neurol:母乳喂养与婴儿抗癫痫药物暴露

2020-01-06 MedSci MedSci原创

总的来说,母乳喂养婴儿血液样本中的抗癫痫药物浓度大大低于母亲血液浓度。鉴于母乳喂养的好处以及哺乳期抗癫痫药物的疗效和安全性,支持抗癫痫药物治疗的同时坚持母乳喂养。

母乳喂养对婴幼儿抗癫痫药物暴露的影响研究十分有限

近日研究人员开展这项前瞻性队列研究,研究在2012年12月至2016年10月期间进行,全美20个地区的儿童参与,随访至6岁,收集母乳喂养婴儿的抗癫痫药物暴露信息。研究的主要终点为抗癫痫药物母婴浓度的百分比(母体浓度/幼儿浓度)。

共有351名女性以及其345名婴儿(179名女性儿童[51.9%];中位年龄,13周)入选。在345名婴儿中,222名(64.3%)接受母乳喂养。哺乳期婴儿所有抗癫痫药物浓度低于49%的下限。所有7种抗癫痫药物和1代谢物(卡马西平、卡马西平-10,11-环氧化物,左乙拉西坦,拉莫三嗪,奥卡西平,托吡酯,丙戊酸钠,唑尼沙胺)的母婴浓度中位数百分比从0.3%到44.2%。在多元线性回归模型中,母体浓度是与婴儿拉莫三嗪浓度的正相关因素,而与左乙拉西坦浓度无关。

总的来说,母乳喂养婴儿血液样本中的抗癫痫药物浓度大大低于母亲血液浓度。鉴于母乳喂养的好处以及哺乳期抗癫痫药物的疗效和安全性,支持抗癫痫药物治疗的同时坚持母乳喂养。

原始出处:

Angela K. Birnbaum et al. Antiepileptic Drug Exposure in Infants of Breastfeeding Mothers With Epilepsy.JAMA Neurol. December 30,2019.

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    2020-11-11 yinhl1978
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    2020-01-08 villahu
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1716053, encodeId=9c6d1e1605373, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Tue Jul 21 23:36:00 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000952, encodeId=307f200095203, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Nov 11 15:36:00 CST 2020, time=2020-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1958112, encodeId=d6dc1958112f9, content=<a href='/topic/show?id=4f2f8e771bc' target=_blank style='color:#2F92EE;'>#药物暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87771, encryptionId=4f2f8e771bc, topicName=药物暴露)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Tue Mar 31 22:36:00 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1665090, encodeId=a57916650901d, content=<a href='/topic/show?id=c8664008e1a' target=_blank style='color:#2F92EE;'>#喂养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40087, encryptionId=c8664008e1a, topicName=喂养)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0ed425881542, createdName=ms1948154235210413, createdTime=Mon Sep 07 14:36:00 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299621, encodeId=8e6b129962173, content=<a href='/topic/show?id=7a056349485' target=_blank style='color:#2F92EE;'>#母乳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63494, encryptionId=7a056349485, topicName=母乳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf1b289, createdName=villahu, createdTime=Wed Jan 08 10:36:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414713, encodeId=e0211414e1320, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Wed Jan 08 10:36:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035855, encodeId=1d731035855dd, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 06 22:36:00 CST 2020, time=2020-01-06, status=1, ipAttribution=)]
    2020-01-06 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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患儿女,6岁,因“生长发育迟缓,反复抽搐发作3年”收治于中国科学技术大学附属第一医院(安徽省立医院)癫痫外科。患儿3岁时首次发作,表现为睡梦中突然惊醒,随即双眼凝视、意识丧失、呼之不应、口唇青紫、流涎、四肢强直.阵挛,每次持续2-3min,2-3次/周在当地医院行短程EEG检查提示:异常睡眠脑电图,棘、棘-慢复合波(额、顶、枕部),随即予以左乙拉西坦抗癫痫治疗,强直.阵挛的发作症状有所好转,但常于

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研究认为,芬氟拉明可显著降低Dravet综合征患者痉挛性发作频率,且总体耐受性良好