丙戊酸钠联合左乙拉西坦治疗小儿颅脑损伤后继发性癫痫临床观察  

Clinical observation of sodium valproate combined with levetiracetam in the treatment of secondary epilepsy after craniocerebral injury in children

作　　者：张景杰 蔡西国[2] ZHANG Jingjie;CAI Xiguo(The Third People’s Hospital of Shangqiu,Shangqiu 476000,China;Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]商丘市第三人民医院,河南商丘476000 [2]河南省人民医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2021年第17期1531-1537,共7页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:2017T02057)。

摘　　要：目的研究颅脑损伤后继发性癫痫的患儿接受丙戊酸钠联合左乙拉西坦治疗的临床效果,并探讨对神经保护作用和炎症因子白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)的影响。方法纳入2014-01—2019-02商丘市第三人民医院收治的87例颅脑损伤后继发性癫痫患儿,对照组43例,联合组44例,对照组给予丙戊酸钠治疗,联合组给予丙戊酸钠和左乙拉西坦的联合治疗,比较2组临床治疗效果、炎症因子白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)水平变化及神经功能改善情况。结果联合组治疗总有效率90.91%,高于对照组的76.74%,组间对比差异有统计学意义(P<0.05);联合组治疗6个月后IL-6、hs-CRP水平低于对照组,差异有统计学意义(P<0.05);联合组治疗3个月、6个月后神经功能评分分别为(17.55±4.02)分、(13.65±3.29)分,均低于对照组的(20.19±4.27)分、(16.67±3.74)分,组间比较差异有统计学意义(P<0.05)。结论小儿颅脑损伤后继发性癫痫给予丙戊酸钠联合左乙拉西坦治疗能够更明显降低炎症因子水平,改善患儿神经功能,提升整体治疗有效性。Objective To study the clinical effect of sodium valproate combined with levetiracetam in children with secondary epilepsy after craniocerebral injury,and to explore the effects on neuroprotective effects and inflammatory factors such as interleukin-6 (il-6) and high sensitivity c-reactive protein (hs-crp).Methods From January 2014 to February 2019,87 children with secondary epilepsy after craniocerebral injury admitted to the Third People’s Hospital of Shangqiu were enrolled,43 cases in the control group and 44 cases in the combination group,the control group was treated with sodium valproate,and the combination group was given Combination therapy of sodium valproate and levetiracetam,comparing the clinical effects of the two groups,the changes in the levels of inflammatory factors interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and the improvement of neurological function.Results The total effective rate of the combined group was 90.91%,higher than that of the control group(76.74%),and the difference between the groups was significant(P<0.05).After 6months of treatment,the levels of inflammatory indicators IL-6 and hs-CRP in the combined group were lower than those in the control group,with statistically significant differences(P<0.05).The neurological function scores of the combined group were(17.55±4.02)and(13.65±3.29)after 3 and 6 months of treatment,respectively,which were lower than those of the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion Sodium valproate combined with levetiracetam in children with secondary epilepsy after craniocerebral injury can significantly reduce the level of inflammatory factors,improve the neurological function of children,and enhance the effectiveness of overall treatment.

关 键 词：丙戊酸钠 左乙拉西坦 小儿颅脑损伤 继发性癫痫 炎症因子 神经功能 

分 类 号：R651.15[医药卫生—外科学]