文献类型：期刊文献

中文题名：左乙拉西坦预防小儿热性惊厥复发疗效的Meta分析

英文题名：A meta-analysis of levetiracetam on prevention of recurrent febrile seizures in children

作者：徐晓楠[1];代珊珊[2];宋攀[3];陈永前[1];刘姝娆[4];张妮[5]

第一作者：徐晓楠

机构：[1]兰州大学第二医院儿童医院神经消化科;[2]兰州大学第一临床医学院;[3]郑州大学第一附属医院研究生院;[4]甘肃中医药大学研究生院;[5]兰州大学第二医院儿童医院小儿重症医学科

第一机构：兰州大学第二医院儿童医院神经消化科

年份：2016

卷号：31

期号：7

起止页码：774

中文期刊名：临床荟萃

外文期刊名：Clinical Focus

语种：中文

中文关键词：惊厥,发热性;左乙拉西坦;评价研究;Meta分析

外文关键词：seizures, febrile; levetiracetam; evaluation studies; meta-analysis

摘要：目的系统评价左乙拉西坦预防小儿热性惊厥复发的有效性与安全性。方法计算机检索PubMed、The Cochrane Library、Embsae、CBM、Wan fang Data、VIP和CNKI数据库,查找关于以左乙拉西坦为干预措施预防小儿热性惊厥复发的随机对照试验,并追查纳入排除文献的参考文献。检索时限均从建库至2016年3月20日。由2名研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.2软件进行Meta分析。结果共纳入5个研究,共计475例患者。Meta分析结果显示:与常规退热治疗相比,左乙拉西坦可以明显降低热性惊厥的复发率[RR=0.30,95%CI(0.21,0.43),P<0.01];不能降低癫痫发生率[RR=1.11,95%CI(0.26,4.79),P=0.89];同时会增加不良反应发生率[RR=4.36,95%CI(1.01,18.76),P=0.05]。结论左乙拉西坦在预防小儿热性惊厥复发方面具有较好的疗效,不能降低癫痫发生率,会增加不良反应发生,由于纳入研究存在偏倚可能,尚需更多高质量、多中心、大规模RCT进一步验证。
Objective To systematically review the clinical efficacy and security of levetiracetam reducing the recurrence rate of febrile seizures. Methods Databases such as PubMed, Cochrane Library, Embase, CBM, Wan fang Data, VIP and CNKI were searched in levetiracetam as interventions in the treatment of febrile seizures from inception to March 20th, 2016. Literature screening, extracting data and evaluating methodological quality were independently performed by two reviewers. Meta-analysis was conducted using RevMan 5.2 software. Results A total of 5 studies involving 475 patients were included. Meta-analysis showed that compared with conventional method of antifebrile, levetiracetam can significantly reduce the recurrence rate of febrile seizures than the conventional antifebrile method （RR =0.30, 95% CI [0.21,0.43], P 〈0.01）; but can not reduce the incidence rate of epilepsy （RR = 1.11, 95% CI [0.26,4.79], P = 0.89） ; and can increase the incidence rate of adverse reactions （ RR = 4.36, 95% CI [-1.01,18.76], P =0.05）. Conclusion Levetiracetam can significantly reduce the recurrence rate of febrile seizures, and can not reduce the rate of epilepsy, but increase the incidence of adverse reactions.