奥卡西平与左乙拉西坦联合治疗对局灶性癫痫患儿神经损伤及认知功能改善的影响  

Effect of Oxcarbazepine combined with Levetiracetam on neurological impairment and cognitive function in children with focal epilepsy

作　　者：王玉梅[1] WANG Yu-mei(Department of Pediatrics,Shangqiu the First Peoples Hospital,Shangqiu,Henan 476100,China)

机构地区：[1]商丘市第一人民医院儿科,河南商丘476100

出　　处：《医药论坛杂志》2022年第1期56-59,共4页Journal of Medical Forum

摘　　要：目的探讨选择奥卡西平与左乙拉西坦联合方案给予局灶性癫痫患者治疗的临床效果。方法选取2019年5月—2021年5月在商丘市第一人民医院诊治的60例局灶性癫痫患儿作为对象开展前瞻性研究,经随机数字表法进行分组。给予单药组患儿奥卡西平治疗,给予联合组患儿奥卡西平+左乙拉西坦治疗。服用相应药物治疗6个月后,观察并对比患儿临床治疗有效性、神经损伤及认知功能改善情况等。结果治疗后联合组癫痫发作频率低于单药组,总有效率为90.00%(27/30),高于单药组的66.67%(20/30),差异有统计学意义(t=10.073,χ^(2)=4.812,均P<0.05);治疗后联合组血清维酸蛋白(GFAP)、高迁移率族蛋白(HMGB1)水平以及S-100β蛋白(S-100β)、神经元特异性烯醇化酶(NSE)水平相比单药组均更低,差异有统计学意义(t=3.892、4.826、7.129、4.311,均P<0.05);治疗后联合组蒙特利尔认知功能量表(MoCA)评分及韦氏儿童智力测试量表中语言、操作智商评分和总智商评分均高于单药组,差异有统计学意义(t=3.929、3.064、3.652、3.900,均P<0.05)。结论局灶性癫痫患儿临床治疗中同时使用奥卡西平、左乙拉西坦两种药物,可明显提高临床疗效,且可明显减轻患儿神经及认知功能损伤。Objective To evaluate the clinical efficacy of Oxcarbazepine combined with Levetiracetam in the treatment of focal epilepsy.Methods A total of 60 children with focal epilepsy who were treated in our hospital from May 2019 to May 2021 were selected and divided into groups by random number table method.The children in the single drug group were treated with Oxcarbazepine, and the children in the combined group were treated with Oxcarbazepine and Levetiracetam.After 6 months of treatment, the clinical efficacy, neurological damage and cognitive function of the children were observed and compared.Results The total effective rate was 90.00%(27/30), which was higher than that of 66.67%(20/30)(t=10.073,χ^(2)=4.812,all P<0.05);The levels of serum GFAP, HMGB1, S-100 β and NSE in the combined group were lower than those in the single group after treatment(t=3.892,4.826,7.129,4.311,all P<0.05);After treatment, the MOCA scores, verbal IQ scores and total IQ scores of the combined group and the Wechsler Intelligence Scale for children were all higher than those of the single drug group(t=3.929,3.064,3.652,3.900,all P<0.05).Conclusion Oxcarbazepine and Levetiracetam were used in the treatment of children with focal epilepsy, can obviously improve the clinical curative effect, and can obviously alleviate the damage of nerve and the cognition function.

关 键 词：儿童局灶性癫痫 左乙拉西坦 奥卡西平 神经损伤 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]