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目的探究中低剂量左乙拉西坦(levetiracetam,LEV)作为成人部分性癫痫患者初始治疗的疗效及其可能的预测因素。方法回顾2011年3月—2015年12月就诊于四川大学华西医院癫痫门诊并纳入癫痫门诊数据库的患者资料,从中筛选出新诊断部分性癫痫且以LEV作为初始治疗的成人患者,分析其疗效与其他临床资料。结果共纳入96例患者,71例达到1年无痫性发作,其中48例(50.0%)经LEV单药治疗后即达到无痫性发作,23例(24.0%)在LEV初始治疗后添加其他抗癫痫药物后达到1年无痫性发作。71例患者中,69例(97.2%)通过中低剂量的LEV(500~1 500 mg/d)单药或联合其他抗癫痫药物即达到无痫性发作。在多因素logistic回归模型中,初始治疗前的基线发作频率高可预测LEV初始治疗疗效不佳(P=0.019)。结论中低剂量LEV作为成人部分性癫痫患者的初始治疗疗效及耐受性均较好。初始治疗前的基线发作频率高是LEV初始治疗疗效不佳的独立预测因素。
Objective To investigate the efficacy and possible predictors of low- and medium-dose levetiracetam (LEV) as initial treatment for adult partial epilepsy. Methods From March 2011 to December 2015, we reviewed the data of patients admitted to epilepsy clinic of West China Hospital of Sichuan University and included in the Epilepsy Outpatient Database, and screened out adult patients with newly diagnosed partial epilepsy and LEV as initial treatment, Other clinical data. Results A total of 96 patients were enrolled and 71 of them achieved 1-year absence of seizures. 48 of them (50.0%) achieved seizure-free after treatment with LEV monotherapy and 23 (24.0%) received additional treatment after LEV initial treatment Antiepileptic drugs to achieve a year without epileptic seizures. Of the 71 patients, 69 (97.2%) achieved a seizure-free seizure with low- and mid-dose LEV (500-1,500 mg / d) alone or in combination with other antiepileptic drugs. In the multivariate logistic regression model, a high baseline seizure frequency before initial treatment predicted a poor response to initial LEV treatment (P = .019). Conclusion Low-dose LEV as initial partial treatment of adult patients with epilepsy efficacy and tolerance are better. The high baseline seizure frequency before initial treatment was an independent predictor of poor response to initial LEV treatment.