Chinese General Practice ›› 2025, Vol. 28 ›› Issue (02): 250-256.DOI: 10.12114/j.issn.1007-9572.2024.0031
Special Issue: 儿科最新文章合辑; 用药最新文章合辑
• Drug Use Guide • Previous Articles
Received:
2024-01-10
Revised:
2024-04-20
Published:
2025-01-15
Online:
2024-10-28
Contact:
YUAN Aiyun
通讯作者:
苑爱云
作者简介:
作者贡献:
马湖萍参与研究的构思与设计,负责研究的实施,撰写论文,进行数据的收集与整理,统计学处理,图、表的绘制与展示;任蓉参与部分资料收集;侯梅参与诊疗实施及研究方案制定;苑爱云提出研究目标及构思与设计,负责文章的质量控制与审查,对文章整体负责,监督管理。
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2024.0031
项目 | 数据 |
---|---|
性别(男/女) | 107/85 |
年龄(岁) | 8.7±3.6 |
起病年龄(岁) | 4.5±3.3 |
添加PER前抗癫痫治疗病程(年) | 3.4±3.1 |
癫痫综合征/脑病[例(%)] | 32(16.7) |
发作类型[例(%)] | |
运动性 | 134(69.8) |
非运动性 | 34(17.7) |
运动性并非运动性 | 24(12.5) |
添加PER前发作频率[例(%)] | |
≤2次/月 | 94(49.0) |
>2次/月 | 98(51.0) |
联合使用其他ASMs[例(%)] | |
≤2种 | 118(61.5) |
>2种 | 74(38.5) |
生酮饮食[例(%)] | 8(4.2) |
癫痫手术治疗[例(%)] | 7(3.6) |
基因检测异常[例(%)] | 23(12.0) |
神经系统发育迟滞[例(%)] | 57(29.7) |
首次添加PER年龄(岁) | 7.9±3.6 |
首次添加PER体质量(kg) | 31.1±17.3 |
PER初始剂量(mg/d) | 1.3±0.9 |
PER维持剂量(mg/d) | 3.9±1.9 |
Table 1 Basic information of pediatric patients with refractory epilepsy
项目 | 数据 |
---|---|
性别(男/女) | 107/85 |
年龄(岁) | 8.7±3.6 |
起病年龄(岁) | 4.5±3.3 |
添加PER前抗癫痫治疗病程(年) | 3.4±3.1 |
癫痫综合征/脑病[例(%)] | 32(16.7) |
发作类型[例(%)] | |
运动性 | 134(69.8) |
非运动性 | 34(17.7) |
运动性并非运动性 | 24(12.5) |
添加PER前发作频率[例(%)] | |
≤2次/月 | 94(49.0) |
>2次/月 | 98(51.0) |
联合使用其他ASMs[例(%)] | |
≤2种 | 118(61.5) |
>2种 | 74(38.5) |
生酮饮食[例(%)] | 8(4.2) |
癫痫手术治疗[例(%)] | 7(3.6) |
基因检测异常[例(%)] | 23(12.0) |
神经系统发育迟滞[例(%)] | 57(29.7) |
首次添加PER年龄(岁) | 7.9±3.6 |
首次添加PER体质量(kg) | 31.1±17.3 |
PER初始剂量(mg/d) | 1.3±0.9 |
PER维持剂量(mg/d) | 3.9±1.9 |
时间 | 例数 | 无发作 | 显效 | 有效 | 无效 | 恶化 | 总有效率 |
---|---|---|---|---|---|---|---|
治疗12周 | 192 | 37(19.3) | 39(20.3) | 32(16.7) | 77(40.1) | 7(3.7) | 108(56.3) |
治疗24周 | 182 | 39(21.4) | 52(28.6) | 22(12.1) | 58(31.9) | 11(6.0) | 113(62.1) |
治疗36周 | 175 | 43(24.6) | 57(32.6) | 22(12.6) | 42(24.0) | 11(6.3) | 122(69.7) |
Table 2 Treatment efficacy of pediatric patients with refractory epilepsy at 12,24,and 36 weeks after PER addition therapy
时间 | 例数 | 无发作 | 显效 | 有效 | 无效 | 恶化 | 总有效率 |
---|---|---|---|---|---|---|---|
治疗12周 | 192 | 37(19.3) | 39(20.3) | 32(16.7) | 77(40.1) | 7(3.7) | 108(56.3) |
治疗24周 | 182 | 39(21.4) | 52(28.6) | 22(12.1) | 58(31.9) | 11(6.0) | 113(62.1) |
治疗36周 | 175 | 43(24.6) | 57(32.6) | 22(12.6) | 42(24.0) | 11(6.3) | 122(69.7) |
项目 | 总有效(n=108) | 无效/恶化(n=84) | χ2(t)值 | P值 | 项目 | 总有效(n=108) | 无效/恶化(n=84) | χ2(t)值 | P值 |
---|---|---|---|---|---|---|---|---|---|
年龄(岁) | 8.6±3.7 | 8.7±3.6 | -0.066a | 0.948 | 初次添加PER年龄(岁) | 7.9±3.7 | 7.9±3.6 | -0.066a | 0.948 |
性别[例(%)] | 0.872 | 0.351 | 添加PER年龄分段[例(%)] | 0.249 | 0.969 | ||||
男 | 57(52.8) | 50(59.5) | 0~3岁 | 16(14.8) | 11(13.1) | ||||
女 | 51(47.2) | 34(40.5) | 4~6岁 | 27(25.0) | 23(27.4) | ||||
起病年龄(岁) | 5.2±3.4 | 3.6±2.8 | 3.474a | 0.001 | 7~12岁 | 53(49.1) | 40(47.6) | ||
抗癫痫治疗病程(年) | 3.4±2.7 | 5.1±3.4 | -3.691a | <0.001 | 13~18岁 | 12(11.1) | 10(11.9) | ||
癫痫综合征/脑病[例(%)] | 0.152 | 0.696 | 首次添加PER体质量(kg) | 31.56±17.28 | 30.59±17.60 | 0.380a | 0.704 | ||
是 | 19(17.6) | 13(15.5) | PER初始剂量(mg/d) | 1.32±0.82 | 1.30±1.02 | 0.154a | 0.878 | ||
否 | 89(82.4) | 71(84.5) | PER维持剂量(mg/d) | 3.96±1.73 | 3.90±2.04 | 0.214a | 0.831 | ||
起源类型[例(%)] | 10.353 | 0.006 | 联合使用其他ASMs数量[例(%)] | 6.647 | 0.010 | ||||
全面性起源 | 19(17.6) | 32(38.1) | ≤2种 | 75(69.4) | 43(51.2) | ||||
局灶性起源 | 71(65.7) | 43(51.2) | >2种 | 33(30.6) | 41(48.8) | ||||
未知起源 | 18(16.7) | 9(10.7) | 生酮饮食/外科治疗[例(%)] | 5.786 | 0.016 | ||||
发作形式[例(%)] | 50.378 | <0.001 | 是 | 4(3.7) | 11(13.1) | ||||
运动性 | 97(89.8) | 37(44.0) | 否 | 104(96.3) | 73(86.9) | ||||
非运动性 | 3(2.8) | 31(36.9) | 基因检测异常[例(%)] | 1.732 | 0.188 | ||||
混合性 | 8(7.4) | 16(19.0) | 是 | 10(9.3) | 13(15.5) | ||||
添加PER前发作频率[例(%)] | 22.021 | <0.001 | 否 | 98(90.7) | 71(84.5) | ||||
≤2次/月 | 69(63.9) | 25(29.8) | 精神运动发育迟滞[例(%)] | <0.001 | 0.984 | ||||
>2次/月 | 39(36.1) | 59(70.2) | 是 | 32(29.6) | 25(29.8) | ||||
否 | 76(70.4) | 59(70.2) |
Table 3 Comparison of general data between total effective and total ineffective pediatric patients with refractory epilepsy after 12 weeks of PER addition therapy
项目 | 总有效(n=108) | 无效/恶化(n=84) | χ2(t)值 | P值 | 项目 | 总有效(n=108) | 无效/恶化(n=84) | χ2(t)值 | P值 |
---|---|---|---|---|---|---|---|---|---|
年龄(岁) | 8.6±3.7 | 8.7±3.6 | -0.066a | 0.948 | 初次添加PER年龄(岁) | 7.9±3.7 | 7.9±3.6 | -0.066a | 0.948 |
性别[例(%)] | 0.872 | 0.351 | 添加PER年龄分段[例(%)] | 0.249 | 0.969 | ||||
男 | 57(52.8) | 50(59.5) | 0~3岁 | 16(14.8) | 11(13.1) | ||||
女 | 51(47.2) | 34(40.5) | 4~6岁 | 27(25.0) | 23(27.4) | ||||
起病年龄(岁) | 5.2±3.4 | 3.6±2.8 | 3.474a | 0.001 | 7~12岁 | 53(49.1) | 40(47.6) | ||
抗癫痫治疗病程(年) | 3.4±2.7 | 5.1±3.4 | -3.691a | <0.001 | 13~18岁 | 12(11.1) | 10(11.9) | ||
癫痫综合征/脑病[例(%)] | 0.152 | 0.696 | 首次添加PER体质量(kg) | 31.56±17.28 | 30.59±17.60 | 0.380a | 0.704 | ||
是 | 19(17.6) | 13(15.5) | PER初始剂量(mg/d) | 1.32±0.82 | 1.30±1.02 | 0.154a | 0.878 | ||
否 | 89(82.4) | 71(84.5) | PER维持剂量(mg/d) | 3.96±1.73 | 3.90±2.04 | 0.214a | 0.831 | ||
起源类型[例(%)] | 10.353 | 0.006 | 联合使用其他ASMs数量[例(%)] | 6.647 | 0.010 | ||||
全面性起源 | 19(17.6) | 32(38.1) | ≤2种 | 75(69.4) | 43(51.2) | ||||
局灶性起源 | 71(65.7) | 43(51.2) | >2种 | 33(30.6) | 41(48.8) | ||||
未知起源 | 18(16.7) | 9(10.7) | 生酮饮食/外科治疗[例(%)] | 5.786 | 0.016 | ||||
发作形式[例(%)] | 50.378 | <0.001 | 是 | 4(3.7) | 11(13.1) | ||||
运动性 | 97(89.8) | 37(44.0) | 否 | 104(96.3) | 73(86.9) | ||||
非运动性 | 3(2.8) | 31(36.9) | 基因检测异常[例(%)] | 1.732 | 0.188 | ||||
混合性 | 8(7.4) | 16(19.0) | 是 | 10(9.3) | 13(15.5) | ||||
添加PER前发作频率[例(%)] | 22.021 | <0.001 | 否 | 98(90.7) | 71(84.5) | ||||
≤2次/月 | 69(63.9) | 25(29.8) | 精神运动发育迟滞[例(%)] | <0.001 | 0.984 | ||||
>2次/月 | 39(36.1) | 59(70.2) | 是 | 32(29.6) | 25(29.8) | ||||
否 | 76(70.4) | 59(70.2) |
项目 | 例数 | 多灶弥漫性 | 局灶性 | ||
---|---|---|---|---|---|
前部(前、中、颞前、颞中部) | 后部(枕、顶、颞后部) | 正常 | |||
总有效 | 100 | 19(19.0) | 53(53.0) | 19(19.0) | 9(9.0) |
无效/恶化 | 78 | 31(39.7) | 32(41.0) | 11(14.1) | 4(5.1) |
χ2值 | 9.551 | ||||
P值 | 0.023 |
Table 4 Comparison of electroencephalogram findings between total effective and total ineffective pediatric patients with refractory epilepsy after 12 weeks of PER addition therapy
项目 | 例数 | 多灶弥漫性 | 局灶性 | ||
---|---|---|---|---|---|
前部(前、中、颞前、颞中部) | 后部(枕、顶、颞后部) | 正常 | |||
总有效 | 100 | 19(19.0) | 53(53.0) | 19(19.0) | 9(9.0) |
无效/恶化 | 78 | 31(39.7) | 32(41.0) | 11(14.1) | 4(5.1) |
χ2值 | 9.551 | ||||
P值 | 0.023 |
项目 | 例数 | 正常 | 发育异常 | 以白质损伤为主 | 以灰质损伤为主 | 其他 |
---|---|---|---|---|---|---|
总有效 | 92 | 43(46.7) | 10(10.9) | 19(20.7) | 9(9.8) | 11(12.0) |
无效/恶化 | 75 | 23(30.7) | 18(24.0) | 15(20.0) | 14(18.7) | 5(6.7) |
χ2值 | 10.532 | |||||
P值 | 0.032 |
Table 5 Comparison of brain magnetic resonance imaging findings between total effective and total ineffective pediatric patients with refractory epilepsy after 12 weeks of PER addition therapy
项目 | 例数 | 正常 | 发育异常 | 以白质损伤为主 | 以灰质损伤为主 | 其他 |
---|---|---|---|---|---|---|
总有效 | 92 | 43(46.7) | 10(10.9) | 19(20.7) | 9(9.8) | 11(12.0) |
无效/恶化 | 75 | 23(30.7) | 18(24.0) | 15(20.0) | 14(18.7) | 5(6.7) |
χ2值 | 10.532 | |||||
P值 | 0.032 |
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