不同类型抗癫痫药物对伴中央颞区棘波儿童良性癫痫注意网络损害及脑电图痫样放电的影响  

Effects of different types of antiepileptic drugs on attention network impairment and epileptiform discharge of electroencephalogram in children with benign epilepsy accompanied by central temporal spikes

作　　者：王卫星[1] 付淑芳[1] 陈凤仪[1] 余静[1] WANG Weixing;FU Shufang;CHEN Fengyi;YU Jing(Department of Pediatrics,First People's Hospital of Yichang City,Hubei Province,Yichang 443000,China)

机构地区：[1]湖北省宜昌市第一人民医院儿科

出　　处：《疑难病杂志》2019年第9期904-909,共6页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察不同类型抗癫痫药物(AED)对伴中央颞区棘波儿童良性癫痫(BECT)注意网络损害和脑电图(EEG)痫样放电的影响。方法回顾性分析2015年6月—2018年6月湖北省宜昌市第一人民医院儿科诊治BECT患儿235例的临床资料,根据AED类型不同分为丙戊酸(VPA)、奥卡西平(OXC)及左乙拉西坦(LEV)3组,比较治疗6个月时3组患儿癫痫控制效果、EEG痫样放电改善情况、注意网络功能、认知功能及药物不良反应等指标。结果3组患儿临床治疗总有效率比较差异均无统计学意义(χ^2/P=1.234/0.540);VPA组EEG痫样放电改善总有效率明显低于OXC组和LEV组(χ^2/P=7.253/0.027);3组患儿治疗后6个月警觉网络、定向网络及正确率明显升高,平均反应时间(RT)明显降低(P<0.01),且VPA组和LEV组警觉网络、定向网络及正确率低于OXC组(F/P=5.376/0.005、5.979/0.003、13.676/<0.001),平均RT高于OXC组(F/P=5.694/0.004);3组认知功能VIQ、PIQ及FIQ均明显升高(P<0.01),且OXC组和LEV组均高于VPA组,差异有统计学意义(F/P=14.084/<0.001、3.955/0.020、3.560/0.030);3组患儿不良反应发生率比较差异无统计学意义(χ^2/P=3.165/0.075)。结论VPA、OXC和LEV治疗BECT患儿可有效控制癫痫发作并减少脑电图异常放电,其中OXC对注意网络损害改善效果优于VPA和LEV,OXC和LEV对脑电图和认知功能改善效果优于VPA。Objective To observe the effects of different types of antiepileptic drugs(AED)on attention network impairment and electroencephalogram epileptiform discharges in children with benign epilepsy(BECT)accompanied by central temporal spikes.Methods The clinical data of 235 children with BECT were retrospectively analyzed from June 2015 to June 2018 in the Department of Pediatrics,Yichang First People's Hospital,Hubei Province.According to the types of AED,they were divided into three groups:VPA,OXC,and LEV.The control effect of epilepsy and EEG epilepsy were compared among the three groups at 6 months of treatment.The improvement of discharge pattern,attention network function,cognitive function,and adverse drug reactions were also evaluated.Results There was no significant difference in the total effective rate of clinical treatment among the three groups(χ^2/P=1.234/0.540).The total effective rate of EEG epileptiform discharge improvement in the VPA group was significantly lower than that in the OXC group and LEV group(χ^2/P=7.253/0.027).Six months after treatment,the alert network,directional network and correct rate of the three groups increased significantly,and the average reaction time(RT)decreased significantly.The alert network,directional network and correct rate of VPA group and LEV group were lower than those of the OXC group(F/P=5.376/0.005,5.979/0.003,13.676/<0.001).The average RT was higher in the OXC group than in the OXC group(F/P=5.694/0.004).VIQ,PIQ,and FIQ of cognitive function in three groups were significantly increased(P<0.01),and OXC group and LEV group were higher than VPA group(F/P=14.084/<0.001,3.955/0.020,3.560/0.030).There was no significant difference in the incidence of adverse reactions among the three groups(χ^2/P=3.165/0.075).Conclusion The VPA,OXC,and LEV can effectively control epileptic seizures and reduce abnormal EEG discharges in children with BECT.OXC is better than VPA and LEV in improving attention network impairment.OXC and LEV are better than VPA in improving EEG and co

关 键 词：儿童良性癫痫伴中央颞区棘波 抗癫痫药物 脑电图痫样放电 注意网络 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]