左乙拉西坦联合奥卡西平治疗儿童癫痫的疗效及对患者免疫功能、脑电图及认知功能的影响  

Efficacy of levetiracetam combined with oxcarbazepine in the treatment of childhood epilepsy and its effects on immune function,EEG,and cognitive function

作　　者：陈书远[1] 刘金宝[1] 刘世祺 CHEN Shu-yuan;LIU Jin-bao;LIU Shi-qi(Department of Pediatrics,Huizhou First People's Hospital,Huizhou 516001,Guangdong,CHINA)

机构地区：[1]惠州市第一人民医院儿科,广东惠州516001

出　　处：《海南医学》2022年第7期894-897,共4页Hainan Medical Journal

摘　　要：目的观察左乙拉西坦联合奥卡西平治疗儿童癫痫的疗效,并探讨其对患者免疫功能、脑电图及认知功能的影响。方法选择2018年10月至2020年10月在惠州市第一人民医院接受治疗的49例儿童癫痫患者进行研究。按照随机数表法将患者分为对照组24例和观察组25例,对照组患儿单独服用奥卡西平片药,观察组患儿在对照组用药的基础上同时服用左乙拉西坦口服液,两组患儿均持续治疗16周。比较两组患儿治疗前后的免疫功能指标(IgA、IgM、IgG、CD3^(+)、CD4^(+))、脑电图(EEG)和认知功能[全量表智商(FIQ)、操作智商(PIQ)、言语智商(VIQ)]变化,同时比较两组患儿的临床疗效和治疗期间的不良反应发生情况。结果治疗后,两组患儿的IgM、IgG、IgA水平均明显降低,CD4^(+)、CD3^(+)水平明显升高,FIQ、PIQ、VIQ明显提高,差异均有统计学意义(P<0.05);治疗后,观察组患儿的IgA、IgM、IgG水平分别为(0.26±0.07)g/L、(0.74±0.27)g/L、(6.48±1.20)g/L,明显低于对照组的(0.38±0.14)g/L、(0.93±0.28)g/L、(8.32±1.58)g/L,CD4^(+)、CD3^(+)水平分别为(40.30±8.11)%、(62.02±9.34)%,明显高于对照组的(35.23±7.52)%、(54.26±9.06)%,差异均有统计学意义(P<0.05);治疗后,观察组患儿的FIQ、PIQ、VIQ评分分别为(99.35±0.93)分、(98.34±1.07)分、(98.48±1.83)分,明显高于对照组的(98.14±1.02)分、(96.38±1.18)分、(96.41±1.67)分,差异均有统计学意义(P<0.05);治疗后,观察组患儿的痫样放电治疗有效率为96.00%,明显高于对照组的79.17%,差异有统计学意义(P<0.05);治疗期间两组患儿均未发生严重不良反应,总不良反应率比较差异无统计学意义(P>0.05)。结论左乙拉西坦与奥卡西平联合用药抗癫痫治疗,不仅能够减少患儿癫痫的发作频次,有效控制痫样放电,改善患儿的EEG及认知功能,而且还有效调节其自身免疫功能,达到了神经免疫双向调节。Objective To observe the efficacy of levetiracetam combined with oxcarbazepine in the treatment of epilepsy in children,and to explore its effects on immune function,electroencephalogram(EEG),and cognitive function.Methods Forty-nine children with epilepsy treated in Huizhou First People’s Hospital from October 2018 to October 2020 were selected for study.The patients were randomly divided into a control group(n=24)and an observation group(n=25)according to the random number method.Patients in the control group took oxcarbazepine tablets alone,and those in the observation group took levetiracetam oral liquid on the basis of the control group.After 16 weeks of continuous treatment,the changes of immune function indexes(IGA,IgM,IgG,CD3^(+),CD4^(+)),EEG,and cognitive function[Full Scale IQ(FIQ),operational IQ(PIQ),and verbal IQ(VIQ)]before and after treatment were compared.At the same time,the clinical efficacy and adverse reactions of the two groups were compared.Results After treatment,the levels of IgM,IgG,and IgA decreased significantly,the levels of CD4^(+) and CD3^(+) increased significantly,and the levels of FIQ,PIQ and VIQ increased significantly in the two groups(P<0.05).After treatment,the levels of IgA,IgM,and IgG in the observation group were(0.26±0.07)g/L,(0.74±0.27)g/L,(6.48±1.20)g/L,which were significantly lower than(0.38±0.14)g/L,(0.93±0.28)g/L,(8.32±1.58)g/L in the control group,and the levels of CD4^(+) and CD3^(+) were(40.30±8.11)%,(62.02±9.34)%,which were significantly higher than(35.23±7.52)%(54.26±9.06)% in the control group;the differences were statistically significant(P<0.05).After treatment,the scores of FIQ,PIQ and VIQ in the observation group were(99.35±0.93)points,(98.34±1.07)points,and(98.48±1.83)points,respectively,which were significantly higher than(98.14±1.02)points,(96.38±1.18)points,and(96.41±1.67)points in the control group(P<0.05).After treatment,the effective rate of epileptiform discharge in the observation group was 96.00%,which was significantly higher tha

关 键 词：癫痫 儿童 左乙拉西坦 奥卡西平 免疫功能 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]