肾功能损害患者静脉注射左乙拉西坦治疗的临床结果。
Clinical outcomes of intravenous levetiracetam treatment in patients with renal impairment.
作者信息
Lapmag Anyamanee, Lertsinudom Sunee, Chaiyakam Aporanee, Sawanyawisuth Kittisak, Tiamkao Somsak
机构信息
Cinical Pharmacy Division, Faculty of Pharmaceutical Sciences, Khon Kaen University.
The College of Pharmacotherapy of Thailand, Pharmacy Council, Bangkok.
出版信息
Neurol Int. 2018 Sep 25;10(3):7469. doi: 10.4081/ni.2018.7469. eCollection 2018 Sep 5.
Intravenous levetiracetam has been approved for use as an antiepileptic drug, as well as in cases of status epilepticus. There are few reports that detail the clinical data and outcomes associated with this antiepileptic drug, particularly in patients with renal impairment. This was a retrospective analytical study conducted at Khon Kaen University's Srinagarind Hospital in Thailand. The study period was between January 1, 2010 and December 31, 2014. The inclusion criteria were that patents were over 15 years old, had renal impairment, and had received intravenous levetiracetam treatment. The main clinical outcomes were seizure control and mortality. Clinical outcomes were compared between those with and without status epilepticus. Mortality of patients with status epilepticus were compared in terms of seizure control and order of intravenous levetiracetam treatment. During the study period, there were 247 patients who met the study criteria. The average age of the patients was 58 years with nearly equal sex distribution. Of those, 90 patients (36.4%) had GRFs of less than 15 mL/min/1.73 m and 60 patients (24.3%) received intravenous LEVE due to status epilepticus. The seizure control rates in the status epilepticus and non-status epilepticus groups were 36.7% and 88.7%, respectively (P<0.001). The mortality rate did not differ significantly between the two groups (33.3% 27.8%; P=0.418). There was no significant overall difference in mortality rate between seizure-controlled and seizure-uncontrolled patients in the status epilepticus group. In the convulsive status epilepticus group, variations in terms of treatment order of intravenous levetiracetam and seizure control resulted in no significant difference in mortality rates (P=0.311). No major side effects were detected in any patients after the intravenous levetiracetam treatment. In conclusion, intravenous levetiracetam treatment was effective and safe in patients with renal impairment.
静脉注射左乙拉西坦已被批准用作抗癫痫药物，也用于癫痫持续状态的治疗。很少有报告详细说明与这种抗癫痫药物相关的临床数据和结果，尤其是在肾功能损害患者中。这是一项在泰国孔敬大学诗里拉吉医院进行的回顾性分析研究。研究期间为2010年1月1日至2014年12月31日。纳入标准为患者年龄超过15岁、有肾功能损害且接受过静脉注射左乙拉西坦治疗。主要临床结果为癫痫控制和死亡率。比较了有癫痫持续状态和无癫痫持续状态患者的临床结果。根据癫痫控制情况和静脉注射左乙拉西坦治疗顺序比较了癫痫持续状态患者的死亡率。在研究期间，有247名患者符合研究标准。患者的平均年龄为58岁，性别分布几乎相等。其中，90名患者（36.4%）的肾小球滤过率低于15 mL/min/1.73 m²，60名患者（24.3%）因癫痫持续状态接受了静脉注射左乙拉西坦治疗。癫痫持续状态组和非癫痫持续状态组的癫痫控制率分别为36.7%和88.7%（P<0.001）。两组的死亡率无显著差异（33.3%对27.8%；P=0.418）。癫痫持续状态组中癫痫得到控制和未得到控制的患者之间的死亡率总体上无显著差异。在惊厥性癫痫持续状态组中，静脉注射左乙拉西坦的治疗顺序和癫痫控制情况的变化导致死亡率无显著差异（P=0.311）。静脉注射左乙拉西坦治疗后，未在任何患者中检测到严重副作用。总之，静脉注射左乙拉西坦治疗对肾功能损害患者有效且安全。
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