Page 90 - 《中国药房》2024年4期

·药物与临床·

拉考沙胺与卡马西平治疗成人新诊癫痫的有效性和安全性对比
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郭夏青 ，李郭飞，孙玉华，郑东琳（河南大学淮河医院神经内科一病区，河南 开封 475000）
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中图分类号 R742.1；R969.4 文献标志码 A 文章编号 1001-0408（2024）04-0464-04
DOI 10.6039/j.issn.1001-0408.2024.04.15

摘 要 目的 比较拉考沙胺（LCM）与卡马西平（CAR）单药治疗成人新诊癫痫患者的有效性和安全性。方法 采用回顾性分析
方法，根据用药方案的不同，将2020年9月－2022年6月河南大学淮河医院神经内科收治的新诊癫痫患者（84例）分为对照组（40
例，接受CAR治疗）和观察组（44例，接受LCM治疗），比较两组患者的总有效率、癫痫发作频率、血脂水平和不良事件（AEs）发生
情况。结果 治疗后第1个月，观察组患者的总有效率（63.64%）与对照组（55.00%）比较，差异无统计学意义（P＞0.05）；两组患者
的癫痫发作频率均较治疗前显著减少（P＜0.05），但组间比较差异无统计学意义（P＞0.05）。治疗后第3个月，观察组患者的总有
效率（90.91%）显著高于对照组（67.50%，P＜0.05）；两组患者的癫痫发作频率亦较治疗前显著减少，且观察组显著少于对照组
（P＜0.05）。治疗后第3个月，对照组患者的TC、TG、LDL-C水平以及观察组患者的LDL-C水平均较同组治疗前显著升高，且观察
组患者的TC、TG、LDL-C水平均显著低于对照组（P＜0.05）。观察组患者的AEs发生率（15.91%）与对照组（17.50%）比较，差异无
统计学意义（P＞0.05）。结论 LCM和CAR在成人新诊癫痫患者的治疗中均具有一定效果，均可降低患者的癫痫发作频率，且安
全性相当。同时，LCM的长期疗效优于CAR，对患者血脂水平的影响小于CAR。
关键词 拉考沙胺；卡马西平；新诊癫痫；成人患者；有效性；安全性

Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with
newly diagnosed epilepsy
GUO Xiaqing，LI Guofei，SUN Yuhua，ZHENG Donglin（First Ward， Dept. of Neurology， Huaihe Hospital of
Henan University， Henan Kaifeng 475000， China）

ABSTRACT OBJECTIVE To compare the efficacy and safety of lacosamide （LCM） and carbamazepine （CAR） as monotherapy
in the treatment of adult patients with newly diagnosed epilepsy. METHODS By methods of retrospective analysis， 84 adult
patients with newly diagnosed epilepsy， were admitted to the Department of Neurology， Huaihe Hospital of Henan University
during Sept. 2020-Jun. 2022， were divided into the control group （40 cases， receiving CAR treatment） and the observation group
（44 cases， receiving LCM treatment） according to different medication regimens. Total response rate， epilepsy seizure frequency，
blood lipid levels， and the occurrence of adverse events （AEs） of patients were compared between the 2 groups. RESULTS In the
first month after treatment， there was no statistically significant difference in the total response rate between the observation group
（63.64%） and the control group （55.00%， P＞0.05）； the frequency of epilepsy seizure in both groups was significantly reduced
compared to before treatment （P＜0.05）， but there was no statistically significant difference between 2 groups （P＞0.05）. In the
third month after treatment， the total response rate of the observation group （90.91%） was significantly higher than control group
（67.50%， P＜0.05）； the frequencies of epilepsy seizure in both groups were significantly reduced compared to before treatment，
and the observation group was significantly lower than the control group （P＜0.05）. In the third month after treatment， the levels
of total cholesterol （TC）， triglyceride （TG） and low-density lipoprotein cholestrol （LDL-C） in the control group and the level of
LDL-C in the observation group were significantly higher than before treatment， and the levels of TC， TG and LDL-C in the
observation group were significantly lower than those in the control group （P＜0.05）. There was no statistically significant
difference in the incidence of AEs between the observation group （15.91%） and the control group （17.50%， P＞0.05）.
CONCLUSIONS Both LCM and CAR have certain effects in the treatment of newly diagnosed epilepsy in adults， which can
reduce the frequency of epilepsy seizure in patients and have comparable safety. Meanwhile， LCM has better long-term efficacy
than CAR in treating newly diagnosed epilepsy in adults， and
Δ 基金项目 河南省科技发展计划（No.212102310830）
＊第一作者 主治医师，硕士。研究方向：脑血管病、帕金森病。 its impact on the patient’s blood lipid is smaller than CAR.
E-mail：guoxiaqing2002@163.com KEYWORDS lacosamide； carbamazepine； newly diagnosed
# 通信作者 副主任医师。研究方向：癫痫的诊治。E-mail： epilepsy； adult patient； efficacy； safety
96299736223@qq.com

· 464 · China Pharmacy 2024 Vol. 35 No. 4 中国药房 2024年第35卷第4期