癫痫杂志

癫痫杂志

拉科酰胺在癫痫持续状态中的应用  —针对现有证据的系统评价

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拉科酰胺(Lacosamide,LCM)的静脉制剂具有良好的耐受性和安全性,促使其在癫痫持续状态(Status Epilepticus,SE)中得到应用。本项系统评价的目的是确定和评估 LCM 在 SE 中的使用情况。在电子数据库中用联合检索方式对 2008 年—2016 年 10 月的文献进行了系统检索,并使用标准化的评估表格从各项研究中将有关研究设计、方法框架、数据源、有效性和 LCM 引起的不良反应的信息进行提取并系统地报告。研究共评估了 522 次 SE 发作,其中包括 486 例成人和 36 例儿童及青少年发作,女性占 51.7%。LCM 的总体效力为 57%。LCM 对非惊厥性(57%,82/145)和全面痉挛性(61%,30/49,P=0.68)SE 的效力相似,但对局灶运动性 SE 的总体有效率更高(92%,34/39,P<0.001)。而 LCM 在用药次序靠后时其疗效从 100%下降到 20%。治疗期间的主要不良反应是眩晕,视力异常,复视和共济失调。总体而言,LCM 具有良好的耐受性,并且没有具临床意义的药物相互作用。现有数据表明 LCM 在 SE 中的使用是有前景的,有效率为 57%。LCM 的优势在于没有潜在的药物相互作用,并且在紧急情况需迅速增加剂量时可静脉使用。

关键词: 拉科酰胺; 癫痫持续状态; 痫性发作; 癫痫; 电压门控钠通道

引用本文: AdamStrzelczyk, JohannPhilipp Zollner, LaurentM Willems, 肖英凤 译, 童馨 慕洁 审. 拉科酰胺在癫痫持续状态中的应用  —针对现有证据的系统评价. 癫痫杂志, 2018, 4(5): 446-460. doi: 10.7507/2096-0247.20180073 复制

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