丙戊酸钠联合托吡酯对部分发作性癫痫患儿的临床疗效分析  

Analysis of clinical curative effect of sodium valproate combined with topiramate on children with partial epilepsy

作　　者：马新强[1] 赵默 甄恩迪 武树超[2] MA Xinqiang;ZHAO Mo;ZHEN Endi;WU Shuchao(Nanyang Central Hospital,Nanyang 473000,China;The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000 [2]南阳医学高等专科学校第一附属医院,河南南阳473000

出　　处：《中国实用神经疾病杂志》2020年第15期1318-1322,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划普通项目(编号:201702127)。

摘　　要：目的探讨丙戊酸钠联合托吡酯对部分发作性癫痫患儿脑电图及血清神经元特异性烯醇化酶(NSE)、同型半胱氨酸(Hcy)、神经肽Y(NPY)的影响。方法选取2017-01—2019-12南阳中心医院诊治的102例部分发作性癫痫患儿,随机分为2组。分别给予丙戊酸钠联合托吡酯治疗(联合组,53例)和丙戊酸钠治疗(单药组,49例)。对比2组治疗3个月后脑电图改善情况、血清指标及认知功能变化情况。结果治疗3个月后,联合组患儿脑电图改善率为86.79%,明显高于单药组改善率69.39%(P<0.05)。治疗前2组患儿血清NSE、Hcy、NPY水平及各认知功能评分差异无统计学意义(P>0.05);治疗3个月后联合组患儿血清NSE、Hcy水平明显低于单药组(P<0.05),联合组血清NPY水平及视空间、注意、语言、定向、MoCA总分均显著高于单药组(P<0.05)。联合组不良反应总发生率为16.98%,单药组为12.24%,差异无统计学意义(P>0.05)。结论丙戊酸钠联合托吡酯治疗小儿部分发作性癫痫的效果良好,能有效降低患儿血清NSE、Hcy水平,提高血清NPY水平,改善患儿认知功能。Objective To investigate the effects of sodium valproate combined with topiramate on electroencephalogram(EEG)and serum neuron-specific enolase(NSE),homocysteine(Hcy)and neuropeptide Y(NPY)in children with partial epilepsy.Methods 102 children with partial epilepsy diagnosed and treated in our hospital from January 2017 to December 2019were selected and respectively treated with sodium valproate(53 cases in joint group)and topiramate(49 cases in single-drug group).The improvement of EEG,serum index and cognitive function in two groups were compared after 3 months of treatment.Results After 3 months of treatment,the improvement rate of EEG in joint group was 86.79%,which was significantly higher than single-drug group 69.39%(P<0.05).There was no significant difference in serum NSE,Hcy,NPY levels and cognitive function scores between two groups before treatment(P>0.05).After 3 months of treatment,serum NSE,Hcy levels in joint group were significantly lower than single-drug group(P<0.05),and serum NPY level,visual space,attention,language,orientation and MoCA total scores in joint group were significantly higher than single-drug group(P<0.05).During the treatment,the total incidence of adverse reactions was 16.98%in joint group and 12.24%in single-drug group,with no statistically significant difference between groups(P>0.05).Conclusion The effect of sodium valproate combined with topiramate on partial epilepsy in children is good.It can effectively reduce serum NSE,Hcy levels,increase serum NPY level and improve children's cognitive function.

关 键 词：部分发作性癫痫 丙戊酸钠 托吡酯 脑电图 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]