抗发作药物的使用和在疑似或确定的急性症状发作后的结果
Sahar F Zafar1, Adithya Sivaraju2, Clio Rubinos3
1Department of Neurology, Massachusetts General Hospital, Boston.
JAMA neurology
|September 23, 2024
概括
抗发作药物 (ASM) 经常用于急性症状发作和形异常 (EA). 虽然诸如脑损伤和发作类型等因素会影响ASM的使用,但该研究发现ASM与改善患者结果之间没有关联.
科学领域:
- 神经学 神经学
- 临床神经生理学 临床神经生理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗发作药物 (ASM) 通常用于急性症状发作和形异常 (EA).
- 关于影响ASM使用的因素及其对该人群患者结局的影响的数据有限.
研究的目的:
- 为了确定与ASM在急性症状的住院患者的使用相关的因素.
- 探索ASM治疗和患者的结果之间的关系,包括功能状态.
主要方法:
- 一项多中心队列研究包括1172名没有的住院成年人,接受连续电脑电图 (EEG).
- 收集了关于临床和电图发作,形异常 (EA) 和ASM治疗 (住院持续时间≥48小时) 的数据.
- 分析了与ASM治疗相关的因素和在出院和3个月后的格拉斯哥结局表得分.
主要成果:
- 45%的患者接受了ASM治疗;31%的患者在出院时被处方ASM.
- 急性/渐进性脑损伤,神经学/神经外科服务入院和ICU护理与ASM使用增加有关.
- 临床和EA显着与ASM治疗和出院处方的更高几率有关.
- 治疗ASM与出院时或出院后3个月的改善结果没有关联.
结论:
- 病因学和EEG发现与急性症状和EA的ASM处方模式有关.
- 目前的ASM治疗策略似乎没有改善该患者组的功能结果.
- 需要进一步进行比较有效性研究,以指导最佳的ASM使用和持续时间.
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