左乙拉西坦治疗儿童癫痫的疗效及其对肝功能、血清MDA和8-OHDG的影响  

EFFICACY OF LEVETIRACETAM IN TREATMENT OF CHILDHOOD EPILEPSY AND ITS INFLUENCE ON LIVER FUNCTION AND SERUM LEVELS OF MALONDIALDEHYDE AND 8-HYDROXYDEOXYGUANOSINE

作　　者：段瑞强 高慧丽 刘莹[2] DUAN Ruiqiang;GAO Huili;LIU Ying(Department of Pediatrics, Xinzheng People’s Hospital of Henan Province, Xinzheng 451100, China)

机构地区：[1]河南省新郑市人民医院儿科,河南新郑451100 [2]郑州大学第三附属医院儿科

出　　处：《精准医学杂志》2021年第4期312-315,共4页Journal of Precision Medicine

基　　金：河南省医学科技攻关计划项目(201503114)。

摘　　要：目的探讨左乙拉西坦(LEV)治疗儿童癫痫的疗效及其对肝功能、血清丙二醛(MDA)和8-羟基脱氧鸟苷(8-OHDG)的影响。方法选取2017年1月—2019年1月在新郑市人民医院儿科接受治疗的160例癫痫患儿为研究对象。采用随机数字表法将患者随机分为观察组(n=80)与对照组(n=80),分别给予LEV和丙戊酸钠(VPA)治疗。比较两组患者治疗前后的肝功能、血清MDA与8-OHDG水平及不良反应发生情况。采用受试者工作特征(ROC)曲线分析血清MDA、8-OHDG对患者疗效的评估价值。结果治疗6个月时,观察组治疗总有效率明显高于对照组(χ^(2)=5.331,P<0.05)。观察组治疗前后血清ALT、AST、GGT、MDA、8-OHDG水平比较无显著差异(P>0.05);对照组治疗后血清ALT、AST、GGT水平较治疗前明显升高(t=3.896~4.327,P<0.05),血清MDA、8-OHDG水平较治疗前明显降低(t=8.792、5.014,P<0.05);两组治疗前后血清ALT、AST、GGT、MDA、8-OHDG差值比较差异有显著性(t=4.952~7.258,P<0.05)。ROC曲线结果显示,血清MDA水平预测LEV治疗儿童癫痫有效的AUC为0.857(95%CI=0.755~0.958,P<0.05),诊断的灵敏度和特异度分别为74.2%和78.9%;血清8-OHDG水平预测LEV治疗儿童癫痫有效的AUC为0.823(95%CI=0.706~0.939,P<0.05),诊断的灵敏度和特异度分别为80.6和73.7%。结论LEV治疗儿童癫痫的有效性、安全性优于VPA,LEV能有效降低癫痫患儿血清MDA、8-OHDG水平,且血清MDA、8-OHDG水平对LEV治疗儿童癫痫的疗效有较高的预测价值。Objective To investigate the clinical effect of levetiracetam(LEV)in the treatment of childhood epilepsy and its influence on liver function and the serum levels of malondialdehyde(MDA)and 8-hydroxydeoxyguanosine(8-OHDG).Me-thods A total of 160 children with epilepsy who were treated in Department of Pediatrics,Xinzheng People’s Hospital,from Ja-nuary 2017 to January 2019 were enrolled as subjects and were divided into observation group and control group using a random number table,with 80 children in each group,and the two groups were treated with LEV and valproate(VPA),respectively.The two groups were compared in terms of liver function,serum levels of MDA and 8-OHDG,and adverse reactions before and after treatment.The receiver operating characteristic(ROC)curve was plotted to investigate the value of serum MDA and 8-OHDG in evaluating the treatment outcome of patients.Results The observation group had a significantly higher overall response rate than the control group at month 6 of treatment(χ^(2)=5.331,P<0.05).The observation group had no significant changes in the se-rum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT),MDA,and 8-OHDG after treatment(P>0.05),while after treatment,the control group had significant increases in the serum levels of ALT,AST,and GGT(t=3.896-4.327,P<0.05)and significant reductions in the serum levels of MDA and 8-OHDG(t=8.792,5.014,P<0.05).There were significant differences between the two groups in the changes in the serum levels of ALT,AST,GGT,MDA,and 8-OHDG after treatment(t=4.952-7.258,P<0.05).The ROC curve analysis showed that serum MDA level had an effective AUC of 0.857(95%CI=0.755-0.958,P<0.05)in predicting the efficacy of LEV in the treatment of childhood epilepsy,with a sensitivity of 74.2%and a specificity of 78.9%;serum 8-OHDG level had an effective AUC of 0.823(95%CI=0.706-0.939,P<0.05)in predicting the efficacy of LEV in the treatment of childhood epilepsy,with a sensitivity of 80.6%and a specificity of 73.7

关 键 词：左乙拉西坦 癫痫 丙氨酸转氨酶 天冬氨酸氨基转移酶类 Γ-谷氨酰转肽酶 丙二醛 8-羟基脱氧鸟苷 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]