Hayashi Kitami, Osawa Makiko, Aihara Masao, Izumi Tatsuro, Ohtsuka Yoko, Haginoya Kazuhiro, Kato Ikuko, Kaneko Kenichiro, Sugai Kenji, Takahashi Takao, Hamano Shin-Ichiro, Matsukura Makoto, Miura Hisao, Minagawa Kimio, Yamano Tsunekazu, Yamamoto Hitoshi, Yamanouchi Hideo, Yoshikawa Hideto
Department of Pediatrics, Tokyo Women's Medical University, School of Medicine, Tokyo, Japan.
Pediatr Neurol. 2007 Jun;36(6):366-72. doi: 10.1016/j.pediatrneurol.2007.02.012.
A retrospective multicenter study was conducted, designed to evaluate the efficacy and safety of midazolam for the treatment of status epilepticus. The subjects were 358 inpatients who received intravenous midazolam therapy for status epilepticus. The mean age was 48.6 +/- 46.5 months. The underlying disorder was epilepsy in 195 cases, and acute symptomatic diseases in 163 (encephalitis or encephalopathy in 88 cases). Midazolam was administered as a bolus dose (0.25 +/- 0.21 mg/kg), followed if necessary by continuous infusion (0.26 +/- 0.25 mg/kg/hr). The bolus injection was effective in 162 (56.6%) of the 286 cases. In the end, seizure suppression was obtained in 231 cases (64.5% of the total). The effectiveness of midazolam was lower in patients in whom midazolam was initiated more than 3 hours after seizure onset, and this tendency was particularly marked in the epilepsy group. During the treatment period, 10 patients died, but none of these deaths were associated with midazolam therapy. The incidence and types of adverse events were consistent with previously reported data. The present results indicate that midazolam is highly effective for the management of status epilepticus, if used sufficiently early after seizure onset.
开展了一项回顾性多中心研究，旨在评估咪达唑仑治疗癫痫持续状态的疗效和安全性。研究对象为358例接受静脉注射咪达唑仑治疗癫痫持续状态的住院患者。平均年龄为48.6±46.5个月。基础疾病为癫痫的有195例，急性症状性疾病的有163例（其中88例为脑炎或脑病）。咪达唑仑以推注剂量（0.25±0.21mg/kg）给药，必要时随后持续输注（0.26±0.25mg/kg/小时）。在286例患者中，推注注射对162例（56.6%）有效。最终，231例（占总数的64.5%）实现了癫痫发作抑制。癫痫发作开始后3小时以上开始使用咪达唑仑的患者中，咪达唑仑的有效性较低，且这种趋势在癫痫组中尤为明显。治疗期间，10例患者死亡，但这些死亡均与咪达唑仑治疗无关。不良事件的发生率和类型与先前报告的数据一致。目前的结果表明，如果在癫痫发作后足够早地使用，咪达唑仑对癫痫持续状态的治疗非常有效。
