Li Jing, Zhang Xinyue, Li Nan, Zhao Danyang, Li Guangjian, Lin Weihong
Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2020 Sep 11;11:1013. doi: 10.3389/fneur.2020.01013. eCollection 2020.
To examine the mortality rate and causes of death of phenobarbital (PB) monotherapy and sodium valproate (VPA) monotherapy in patients with convulsive epilepsy in rural northeast China and compare the differences in the results between the two antiepileptic drugs. Patients with convulsive epilepsy were recruited by trained public health workers in a project for epilepsy prevention and treatment. Patients were enrolled between January 2010 and December 2018 and were treated with PB or VPA. Mortality rate (MR), the proportional mortality ratio (PMR) for each cause, standardized mortality ratio, and years of potential life lost (YPLL) for sex, age, and cause were estimated based on the 2018 Chinese rural population. A total of 3,916 patients with convulsive epilepsy enrolled in the study, of whom 3,418 received PB and 498 received VPA. There were 325 reported deaths (300 from the PB group) during the follow-up period. The MRs were 9.96 and 5.73% in the PB and VPA groups, respectively. The overall SMRs were 12.92 (95% confidence intervals [CI]: 11.50-13.93) and 7.39 (95% CI: 4.78-10.91), for the PB and VPA groups, respectively. Cerebrovascular disease and heart disease were the major causes of death in both treatment groups. The average YPLL for the PB group (21.9 years) was higher than that for the VPA group (13.4 years). This is the first epidemiological study to examine the MR of patients with epilepsy in rural northeast China. Our study is somewhat different from previous studies reported in China, and we provide new relevant data from northeast China.
为研究中国东北农村惊厥性癫痫患者接受苯巴比妥(PB)单药治疗和丙戊酸钠(VPA)单药治疗的死亡率及死亡原因,并比较两种抗癫痫药物治疗结果的差异。在一项癫痫防治项目中,由经过培训的公共卫生工作者招募惊厥性癫痫患者。患者于2010年1月至2018年12月入组,并接受PB或VPA治疗。基于2018年中国农村人口,估计死亡率(MR)、各死因的比例死亡率(PMR)、标准化死亡率及按性别、年龄和死因计算的潜在寿命损失年数(YPLL)。共有3916例惊厥性癫痫患者纳入本研究,其中3418例接受PB治疗,498例接受VPA治疗。随访期间报告死亡325例(PB组300例)。PB组和VPA组的MR分别为9.96%和5.73%。PB组和VPA组的总体标准化死亡率分别为12.92(95%置信区间[CI]:11.50 - 13.93)和7.39(95%CI:4.78 - 10.91)。脑血管疾病和心脏病是两个治疗组的主要死亡原因。PB组的平均潜在寿命损失年数(21.9年)高于VPA组(13.4年)。这是第一项研究中国东北农村癫痫患者死亡率的流行病学研究。我们的研究与中国之前报道的研究有所不同,并且我们提供了来自中国东北的新的相关数据。