左乙拉西坦治疗对小儿热性惊厥免疫功能、脑神经因子及预后的影响  

Effects of levetiracetam on the immune function,cranial nerve factors,and prognosis in the treatment of children with febrile convulsion

作　　者：马宁[1] 鱼建飞 王宁 MA Ning;YU Jian-fei;WANG Ning(Department of Pediatrics,Yulin Second Hospital,Yulin 719000,Shaanxi,CHINA;Department of Pediatrics,Xi'an International Medical Center Hospital,Xi'an 710000,Shaanxi,CHINA)

机构地区：[1]榆林市第二医院儿科,陕西榆林719000 [2]西安国际医学中心医院小儿内科,陕西西安710000

出　　处：《海南医学》2021年第18期2374-2377,共4页Hainan Medical Journal

摘　　要：目的研究左乙拉西坦治疗对小儿热性惊厥免疫功能、脑神经因子及预后的影响。方法选取榆林市第二医院儿科于2017年2月至2020年2月收治的78例热性惊厥患儿作为研究对象,根据随机双盲法将患儿分为研究组(常规治疗联合左乙拉西坦治疗)和对照组(常规治疗)各39例,疗程均为15 d。比较两组患儿的临床疗效,治疗前后的免疫功能[血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、CD4^(+)、CD4^(+)/CD8^(+)]、脑神经因子[血清神经元特异性烯醇化酶(NSE)、S-100β蛋白(S-100β)和脑源性神经营养因子(BDNF)水平],以及预后复发转化和不良反应发生情况。结果研究组患儿的临床治疗总有效率为94.87%,明显高于对照组的84.62%,差异有统计学意义(P<0.05);治疗后,两组患儿的IgA、IgG、IgM水平均下降,CD4^(+)、CD4^(+)/CD8^(+)水平均上升,且研究组变化更为明显,差异均具有统计学意义(P<0.05);治疗后,两组患儿的NSE、S-100β、BDNF水平均较治疗前下降,且研究组下降较对照组更明显,差异均具有统计学意义(P<0.05);研究组患者治疗后的复发率和癫痫发生率分别为5.71%、2.86%,明显低于对照组的23.53%、17.65%,差异均有统计学意义(P<0.05);研究组患儿的不良反应率为12.82%,略高于对照组的10.26%,但差异无统计学意义(P>0.05)。结论使用左乙拉西坦治疗小儿热性惊厥能够有效改善患儿的免疫功能及脑神经因子水平,临床疗效显著,预后复发率低、转化癫痫的情况少,且用药安全性较高。Objective To study the effect of levetiracetam on the immune function,cranial nerve factors,and prognosis in the treatment of children with febrile convulsion.Methods Seventy-eight children with febrile seizures ad-mitted to the Department of Pediatrics,Yulin Second Hospital from February 2017 to February 2020 were selected as the research objects.According to the random double-blind method,the children were divided into study group(convention-al treatment combined with levetiracetam)and control group(conventional treatment),with 39 children in each group,all treated for 15 days.The clinical efficacy of the two groups,the immune function before and after treatment(serum Immunoglobulin-A[IgA],immunoglobulin-G[IgG],immunoglobulin-M[IgM],CD4^(+),CD4^(+)/CD8^(+)),cranial nerve factor(neuron specific enolase[NSE],S-100βprotein[S-100β],and brain-derived neurotrophic factor[BDNF]levels),the prognosis,recurrence,transformation,and adverse reactions were compared.Results The total effective rate in the study group was 94.87%,which was significantly higher than 84.62%in the control group(P<0.05).After treatment,the levels of IgA,IgG,and IgM in the two groups were decreased,and the levels of CD4^(+),CD4^(+)/CD8^(+)increased,and the changes in the study group were more significant,with statistically significant difference(P<0.05).After treatment,the levels of NSE,S-100β,and BDNF in the two groups were higher than before treatment,the decrease in the study group was more significant than that in the control group,with statistically significant difference(P<0.05).The recurrence rate and the incidence of epilepsy after treatment in the study group were 5.71%and 2.86%,which were significantly lower than 23.53%and 17.65%in the control group(P<0.05).The adverse reaction rate in the study group was 12.82%,which was slightly higher than 10.26%in the control group,but the difference was not statistically significant(P>0.05).Conclusion The use of levetiracetam in the treatment of febrile seizures can effectively improve the immune

关 键 词：小儿热性惊厥 左乙拉西坦 免疫功能 脑神经因子 预后 

分 类 号：R725[医药卫生—儿科]