左乙拉西坦与苯妥英钠作为治疗儿童惊厥性癫痫持续状态二线药物的疗效及安全性：一项Meta分析
[Efficacy and safety of levetiracetam versus phenytoin as second-line drugs for the treatment of children with convulsive status epilepticus: a Meta analysis].
作者信息
Shi Rui, Yin Huai-Qing, Wang Zhuan-Zhuan
机构信息
First Clinical Medical College, Shanxi Medical University, Taiyuan 030000, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Apr;23(4):356-362. doi: 10.7499/j.issn.1008-8830.2010066.
OBJECTIVE
To systematically evaluate the efficacy and safety of levetiracetam (LEV) versus phenytoin (PHT) as second-line drugs for the treatment of convulsive status epilepticus (CSE) in children.
METHODS
English and Chinese electronic databases were searched for the randomized controlled trials comparing the efficacy and safety of LEV and PHT as second-line drugs for the treatment of childhood CSE. RevMan 5.3 software was used for data analysis.
RESULTS
Seven studies with 1 434 children were included. The Meta analysis showed that compared with the PHT group, the LEV group achieved a significantly higher control rate of CSE (=1.12, 95%:1.00-1.24, =0.05), but there was no significant difference between the two groups in the recurrence rate of epilepsy within 24 hours (=0.82, 95%:0.22-3.11, =0.77) and the rate of further antiepileptic drug therapy (=0.97, 95%:0.64-1.45, =0.87). There was no significant difference in the incidence rate of adverse events between the two groups (=0.77, 95%:0.55-1.09, =0.15).
CONCLUSIONS
LEV has a better clinical effect than PHT in the treatment of children with CSE and does not increase the incidence rate of adverse events.
目的
系统评价左乙拉西坦（LEV）与苯妥英钠（PHT）作为二线药物治疗儿童惊厥性癫痫持续状态（CSE）的疗效和安全性。
方法
检索英文和中文电子数据库，查找比较LEV和PHT作为二线药物治疗儿童CSE疗效和安全性的随机对照试验。使用RevMan 5.3软件进行数据分析。
结果
纳入7项研究，共1434例儿童。Meta分析显示，与PHT组相比，LEV组CSE控制率显著更高（比值比=1.12，95%置信区间：1.00-1.24，P=0.05），但两组在24小时内癫痫复发率（比值比=0.82，95%置信区间：0.22-3.11，P=0.77）和进一步抗癫痫药物治疗率（比值比=0.97，95%置信区间：0.64-1.45，P=0.87）方面无显著差异。两组不良事件发生率无显著差异（比值比=0.77，95%置信区间：0.55-1.09，P=0.15）。
结论
在治疗儿童CSE方面，LEV比PHT具有更好的临床效果，且不增加不良事件发生率。
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