丙戊酸联合拉考沙胺治疗部分性发作癫痫患儿的疗效观察  

Efficacy of valproic acid combined with lacosalamine in the treatment of children with partial seizure epilepsy

作　　者：郭敏[1] 周红亮[1] 徐莉[1] GUO Min;ZHOU Hong-liang;XU Li(Department of Pediatrics,The Second People's Hospital of Lianyungang,Lianyungang Jiangsu 222023,China)

机构地区：[1]连云港市第二人民医院儿科,江苏连云港222023

出　　处：《临床和实验医学杂志》2023年第15期1635-1639,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省“333”工程基金项目(编号:BRA2019248)。

摘　　要：目的分析丙戊酸联合拉考沙胺治疗部分性发作癫痫患儿的疗效。方法前瞻性选取2021年1月至2022年7月连云港市第二人民医院接诊的68例部分性发作癫痫患儿作为研究对象,按照随机数字表法分为对照组和观察组,各34例。对照组予以丙戊酸治疗,丙戊酸25 mg·kg^(-1)·d^(-1),每日2次;观察组予以丙戊酸联合拉考沙胺治疗,丙戊酸25 mg·kg^(-1)·d^(-1),每日2次,拉考沙胺200 mg/d,早晚各服100 mg,两组均维持治疗6个月。比较两组临床疗效、治疗3、6个月后癫痫发作频率、治疗6个月后的炎症因子[白细胞介素(IL)-1β、IL-4、IL-6]水平、癫痫抑郁量表(NDDI-E)评分、广泛性焦虑量表(GAD-7)评分以及不良反应发生情况。结果观察组治疗6个月后无发作率及总有效率分别为52.94%、91.18%,均高于对照组(20.59%、70.59%),无效或加重率为8.82%,低于对照组(29.41%),差异均有统计学意义(P<0.05)。观察组治疗3、6个月后癫痫发作频率分别为(6.35±1.34)、(2.23±0.48)次/月,均低于对照组[(8.26±1.66)、(5.51±1.12)次/月],差异均有统计学意义(P<0.05)。治疗6个月后,观察组IL-1β、IL-4、IL-6水平分别为(8.36±1.24)pg/mL、(1.24±0.27)ng/L、(8.02±0.59)ng/L,均低于对照组[(10.46±1.87)pg/mL、(2.29±0.38)ng/L、(10.46±1.37)ng/L],差异均有统计学意义(P<0.05)。治疗6个月后,观察组NDDI-E评分、GAD-7评分分别为(7.23±1.04)、(3.76±0.77)分,均低于对照组[(9.16±1.57)、(5.01±1.26)分],差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论丙戊酸联合拉考沙胺治疗部分性发作癫痫患儿有确定的疗效,能有效减少病情发作,改善焦虑、抑郁情绪,且安全耐受性较好,值得临床推广应用。Objective To analyze the efficacy of valproic acid combined with lacosalamine in the treatment of children with partial seizure epilepsy.Methods A total of 68 patients with partial seizure epilepsy admitted to The Second People's Hospital of Lianyungan from January 2021 to July 2022 were prospectively selected as research objects and divided into control group and observation group according to the random number table method,with 34 cases in each group.The control group was treated with valproate,25 mg·kg^(-1)·d^(-1),twice a day,and the observation group was treated with valproate and lacosamide,valproate 25 mg·kg^(-1)·d^(-1),twice a day,lacosamide 200 mg/d,100 mg in the morning and evening.Both groups maintained treatment for 6 months.The clinical efficacy,seizure frequency after 3,6 months of treatment,the levels of inflammatory factors[interleukin(IL)-1β,IL-4,IL-6],scores of epileptic depression scale(NDDI-E),generalized anxiety scale(GD-7)after 6 months of treatment and incidence of adverse reactions were compared between the two groups.Results After 6 months of treatment,the seizure free rate and total effective rate in the observation group were 52.94%and 91.18%,respectively,which were higher than those in the control group(20.59%and 70.59%),less ineffective or worse rate was 8.82%,which was lower than that in the control group(29.41%),and the differences were statistically significant(P<0.05).The frequency of seizure in the observation group after 3 and 6 months of treatment were(6.35±1.34)and(2.23±0.48)times/month,respectively,which were lower than those in the control group[(8.26±1.66)and(5.51±1.12)times/month],and the differences were statistically significant(P<0.05).After 6 months of treatment,the levels of IL-1β,IL-4,and IL-6 in the observation group were(8.36±1.24)pg/mL,(1.24±0.27)ng/L,and(8.02±0.59)ng/L,respectively,which were lower than those in the control group[(10.46±1.87)pg/mL,(2.29±0.38)ng/L and(10.46±1.37)ng/L],and the differences were statistically significant(P<0.05).After

关 键 词：癫痫 部分性发作 丙戊酸 拉考沙胺 

分 类 号：R742.1[医药卫生—神经病学与精神病学]