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| 左乙拉西坦联合拉莫三嗪治疗妊娠期癫痫的疗效及对妊娠结局的影响 |
| 王媚瑕1,奚晓雪2,桂千1,吴冠会1,朱伟1,沈明强1,侯晓夏1,赵慧敏1,谈心1,董晓峰1,徐勤荣1,程庆璋1,冯红选1* |
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(1. 南京医科大学附属苏州市立医院神经内科, 苏州 215000;
2. 南京医科大学附属苏州市立医院妇产科, 苏州 215000
*通信作者) |
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| 摘要: |
| 目的 分析左乙拉西坦联合拉莫三嗪治疗妊娠期癫痫的疗效和对妊娠结局的影响。方法 选择2017年1月至2021年2月在南京医科大学附属苏州市立医院门诊及住院治疗的76例妊娠期癫痫患者为研究对象，其中左乙拉西坦单药治疗组20例、拉莫三嗪单药治疗组22例、左乙拉西坦联合拉莫三嗪治疗组34例，对3组妊娠期癫痫患者的癫痫发作频率、妊娠相关并发症及不良妊娠结局进行对比。结果 治疗期间，左乙拉西坦联合拉莫三嗪治疗组妊娠期癫痫无发作、发作频率无变化、发作频率增加、发作频率减少的患者比例分别为82.3%（28/34）、2.9%（1/34）、5.8%（2/34）、8.8%（3/34），左乙拉西坦单药治疗组分别为45.0%（9/20）、25.0%（5/20）、15.0%（3/20）、15.0%（3/20），拉莫三嗪单药治疗组分别为45.5%（10/22）、13.6%（3/22）、18.2%（4/22）、22.7%（5/22），3组间差异有统计学意义（P<0.05）。3组患者妊娠相关并发症及不良妊娠结局的发生率差异均无统计学意义（P均>0.05）。结论 左乙拉西坦联合拉莫三嗪治疗控制妊娠期癫痫发作的效果优于单药治疗，在降低妊娠期癫痫发作频率的同时不增加妊娠相关并发症和不良妊娠结局的发生风险。 |
| 关键词: 左乙拉西坦 拉莫三嗪 妊娠期癫痫 妊娠结局 |
| DOI：10.16781/j.0258-879x.2021.10.1198 |
| 投稿时间：2021-06-30修订日期：2021-08-26 |
| 基金项目:苏州市临床重点病种诊疗技术专项（LCZX201811），苏州市"科教兴卫"青年科技项目（KJXW2019029），CAAE癫痫科研基金-USB基金（2020004B）. |
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| Efficacy of levetiracetam combined with lamotrigine in treating gestational epilepsy and its effect on pregnancy outcomes |
| WANG Mei-xia1,XI Xiao-xue2,GUI Qian1,WU Guan-hui1,ZHU Wei1,SHEN Ming-qiang1,HOU Xiao-xia1,ZHAO Hui-min1,TAN Xin1,DONG Xiao-feng1,XU Qin-rong1,CHENG Qing-zhang1,FENG Hong-xuan1* |
(1. Department of Neurology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou 215000, Jiangsu, China;
2. Department of Obstetrics and Gynaecology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou 215000, Jiangsu, China
*Corresponding author) |
| Abstract: |
| Objective To analyze the efficacy of levetiracetam combined with lamotrigine in the treatment of gestational epilepsy and its effect on pregnancy outcomes. Methods A total of 76 patients with gestational epilepsy in the outpatient or inpatient departments of Suzhou Municipal Hospital Affiliated to Nanjing Medical University from Jan. 2017 to Feb. 2021 were included, including 20 cases in levetiracetam monotherapy group, 22 cases in lamotrigine monotherapy group and 34 cases in combined treatment group (levetiracetam combined with lamotrigine). The epilepsy frequency, pregnancy-related complications and adverse pregnancy outcomes were compared among the 3 groups. Results The proportions of patients with no epilepsy, no change in epilepsy frequency, increase in epilepsy frequency and decrease in epilepsy frequency during pregnancy were 82.3% (28/34), 2.9% (1/34), 5.8% (2/34) and 8.8% (3/34) in the combined treatment group, 45.0% (9/20), 25.0% (5/20), 15.0% (3/20) and 15.0% (3/20) in the levetiracetam monotherapy group, and 45.5% (10/22), 13.6% (3/22), 18.2% (4/22) and 22.7% (5/22) in the lamotrigine monotherapy group, respectively, and the differences were significant among the 3 groups (P<0.05). There were no significant differences in pregnancy-related complications or adverse pregnancy outcomes among the 3 groups (all P>0.05). Conclusion The efficacy of levetiracetam combined with lamotrigine in the treatment of gestational epilepsy is better than that of monotherapy. It can reduce the frequency of gestational epilepsy without increasing the incidence of pregnancy-related complications and adverse pregnancy outcomes. |
| Key words: lamotrigine levetiracetam epilepsy during pregnancy pregnancy outcome |
