左乙拉西坦与苯妥英作为二线用药治疗儿童惊厥性癫痫持续状态的有效性及安全性的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

摘要:

目的 系统评价左乙拉西坦（LEV）和苯妥英（PHT）作为二线用药治疗儿童惊厥性癫痫持续状态（CSE）的有效性及安全性。方法 检索中英文电子数据库，纳入对比LEV和PHT作为二线用药治疗儿童CSE的有效性及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个研究，共1 434名患儿。Meta分析结果显示，LEV组CSE的控制率高于PHT组（RR=1.12，95% CI：1.00~1.24，P=0.05）；24 h内癫痫复发率（RR=0.82，95% CI：0.22~3.11，P=0.77）和需要进一步抗癫痫药物治疗率（RR=0.97，95% CI：0.64~1.45，P=0.87）两组比较差异无统计学意义。两组不良事件发生率差异无统计学意义（RR=0.77，95% CI：0.55~1.09，P=0.15）。结论 LEV治疗儿童CSE的有效性优于PHT，且不增加不良反应的发生率。

Abstract:

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(RR=1.12, 95%CI: 1.00-1.24, P=0.05), but there was no significant difference between the two groups in the recurrence rate of epilepsy within 24 hours(RR=0.82, 95%CI: 0.22-3.11, P=0.77) and the rate of further antiepileptic drug therapy(RR=0.97, 95%CI: 0.64-1.45, P=0.87). There was no significant difference in the incidence rate of adverse events between the two groups(RR=0.77, 95%CI: 0.55-1.09, P=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.