癫痫患儿视频脑电图监测异常与预后的关系  

Relationship between abnormal monitoring of VEEG and prognosis of children patients with epilepsy

作　　者：姜红[1] 韩洁[1] 刘秀珍[1] 张娟[1] 任晋峰[1] 任俊利 薛丽静[1] 秦晓霞 徐宝元[1] 陈欣[1] JIANG Hong;HAN Jie;LIU Xiuzhen(Department of Pediatrics,Central Hospital of Handan City,Hebei,Handan 056001,China)

机构地区：[1]河北省邯郸市中心医院小儿内科

出　　处：《河北医药》2019年第19期3000-3003,共4页Hebei Medical Journal

基　　金：河北省卫健委科研基金项目(编号:20150458)

摘　　要：目的探讨分析癫痫患儿视频脑电图(VEEG)监测异常与预后的关系。方法选取收治的癫痫患儿78例为研究对象,均进行VEEG监测并接受抗癫痫药物治疗,观察不同脑电图结果与临床疗效、免疫功能、认知功能及血清神经元特异性烯醇化酶(NSE)、炎性因子[C-反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)]的关系。结果78例癫痫患儿中检出痫样放电58例,无痫样放电20例。不同癫痫发作类型患儿的痫样放电检出率比较差异无统计学意义(P>0.05)。VEEG痫样放电组、VEEG非痫样放电组治疗总有效率分别为87.93%、100%,VEEG非痫样放电组治疗总有效率显著高于VEEG痫样放电组(P<0.05)。VEEG痫样放电组和VEEG非痫样放电组治疗前IgG、IgA、IgM、CD^+3、CD^+4、CD^+8、CD^+4/CD^+8、VIQ、PIQ、FIQ、NSE、CRP、TNF-α、IL-1β比较差异无统计学意义(P>0.05);VEEG痫样放电组和VEEG非痫样放电组治疗后CD^+3、CD^+4、CD^+4/CD^+8、VIQ、PIQ、FIQ均明显高于治疗前,IgG、IgA、IgM、CD^+8、NSE、CRP、TNF-α、IL-1β均明显低于治疗前(P<0.05),且VEEG非痫样放电组变化程度更明显(P<0.05)。结论癫痫患儿VEEG痫样放电与临床疗效、免疫功能、认知功能及血清NSE、炎性因子均有关,对于预后评估具有重要意义。Objective To investigate the relationship between abnormal monitoring of video electroencephalogram monitoring(VEEG)and prognosis of children patients with epilepsy.Methods A total of 78 children patients with epilepsy who were admitted and treated in our hospital were enrolled in the study.All the patients underwent VEEG monitoring and antiepileptic drug treatment.The correlation between VEEG results and clinical efficacy,immune function,cognitive function as well as the serum levels of NSE and CRP,TNF-αand IL-1βwas analyzed.Results Among the 78 patients,there were 58 cases of epileptiform discharge,and 20 cases without epileptiform discharge.There was no significant difference in the incidence of epileptiform discharges between different types of epileptic children by VEEG monitoring(P>0.05).The total effective rate in VEEG epileptiform discharge group was 87.93%,which was significantly lower than that(100%)in VEEG nonepileptic discharge group(P<0.05).Before treatment,there were no significant differences in the levels of IgG,IgA,IgM,CD^+3,CD^+4,CD^+8,CD^+4/CD^+8,VIQ,PIQ,FIQ,NSE,CRP,TNF-αand IL-1βbetween VEEG epileptiform discharge group and VEEG nonepileptic discharge group(P>0.05).After treatment,the levels of CD^+3,CD^+4,CD^+4/CD^+8,VIQ,PIQ and FIQ were significantly increased in both groups,however,the levels of IgG,IgA,IgM,CD^+8,NSE,CRP,TNF-αand IL-1βwere significantly decreased in both groups(P<0.05).And the improvement degree of above indexes in VEEG nonepileptic discharge group was more significant than that in VEEG epileptiform discharge group(P<0.05).Conclusion The VEEG discharges may be associated with clinical efficacy,immune function,cognitive function and serum levels of NSE and inflammatory cytokines in children patients with epilepsy,which has an important significance in assessing the prognosis of patients.

关 键 词：视频脑电图 小儿癫痫 痫样放电 预后 

分 类 号：R742.1[医药卫生—神经病学与精神病学]