Handoko Kim B, Zwart-van Rijkom Jeannette E F, Visee Huib F, Hermens Walter A J J, Hekster Yechiel A, Egberts Toine C G
Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, The Netherlands.
Epilepsy Behav. 2008 Oct;13(3):545-8. doi: 10.1016/j.yebeh.2008.04.007. Epub 2008 Jul 25.
To optimize seizure control it is important to identify modifiable factors. We conducted a case-control study to explore to what extent drug treatment-related factors are associated with seizures. Eighty-six patients with epilepsy were evaluated: 45 cases (recently experienced a seizure) and 41 controls (seizure-free for at least 2 months). There was a significant association between low AED serum concentration and seizures (odds ratio (OR)=8.9, 95% confidence interval (CI)=1.7-47.8), compliance was not associated with seizures (OR=0.9, 95% CI=0.2-4.0), and changes in medication (mainly non-AEDs) were more frequently observed in the case group than in the control group (OR=4.1, 95% CI=0.9-18.3). These findings indicate that patients with low AED serum levels have a nine times higher risk of seizures compared with patients with therapeutic AED levels and that changes in medication regimens in patients with epilepsy should be made with care.
为优化癫痫控制，识别可改变因素很重要。我们进行了一项病例对照研究，以探讨药物治疗相关因素与癫痫发作的关联程度。对86例癫痫患者进行了评估：45例病例（近期有癫痫发作）和41例对照（至少2个月无癫痫发作）。抗癫痫药物（AED）血清浓度低与癫痫发作之间存在显著关联（优势比（OR）=8.9，95%置信区间（CI）=1.7 - 47.8），依从性与癫痫发作无关联（OR = 0.9，95% CI = 0.2 - 4.0），且病例组比对照组更频繁观察到用药变化（主要是非AEDs）（OR = 4.1，95% CI = 0.9 - 18.3）。这些发现表明，与AED治疗水平的患者相比，AED血清水平低的患者癫痫发作风险高9倍，癫痫患者调整用药方案时应谨慎。
