奥卡西平、拉莫三嗪、左乙拉西坦对伴中央-颞区棘波的自限性癫痫患儿认知功能的影响  

The effects of Oxcarbazepine,Lamotrigine and Levetiracetam on cognitive function of children with self-limited epilepsy with centrotemporal spikes

作　　者：程哲[1] 杜爱玲[2] 陈雷音[1] 郭飞 费鹏鸽[2] 王晶花 杜好瑞[4] 杨世昌[1,5] Cheng Zhe;Du Ailing;Chen Leiyin;Guo Fei;Fei Pengge;Wang Jinghua;Du Haorui;Yang Shichang(Department of Clinical Psychiatry,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,China;Department of Neurology,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,China;Department of Pharmacy,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,China;Department of Electrophysiology,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,China;Department of Clinical Psychology,Hebei Mental Health Center,Baoding 071000,China)

机构地区：[1]新乡医学院第二附属医院精神科,新乡453002 [2]新乡医学院第二附属医院神经内科,新乡453002 [3]新乡医学院第二附属医院药学部,新乡453002 [4]新乡医学院第二附属医院电生理科,新乡453002 [5]河北省精神卫生中心临床心理科,保定071000

出　　处：《中华实用儿科临床杂志》2023年第11期874-880,共7页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230538)。

摘　　要：目的探讨奥卡西平(OXC)、拉莫三嗪(LTG)、左乙拉西坦(LEV)3种新型抗癫痫发作药对伴中央-颞区棘波的自限性癫痫(SeLECTS)患儿的疗效及对认知功能的影响。方法前瞻性研究。选择2014年1月至2020年6月在新乡医学院第二附属医院就诊的98例SeLECTS患儿,按照应用的治疗药物分为OXC组、LTG组、LEV组,于治疗前和治疗48周末分别采集患儿视频脑电图、韦氏儿童智力测验和事件相关电位数据,并比较3组临床疗效和对认知功能的影响。结果1.疗效:治疗后3组患儿发作减少有效率比较差异无统计学意义(χ^(2)=0.808,P=0.668),3组患儿脑电图缓解率比较差异无统计学意义(χ^(2)=0.763,P=0.683)。2.认知功能:(1)韦氏智力测验:①组内比较:OXC组治疗后总智商(FIQ)和言语智商(VIQ)有提升(均P<0.05),理解、词汇、算术、译码、拼物分测验评分均明显提升(均P<0.05);LTG组治疗后FIQ、VIQ和操作智商(PIQ)均明显提升(均P<0.05),理解、词汇、算术、填图、排图分测验评分均明显提升(均P<0.05);LEV组治疗后FIQ、VIQ、PIQ均提升(均P<0.05),其中VIQ较显著,词汇、理解、类同、算术、译码、拼图分测验评分均提升(均P<0.05)。②组间比较:治疗前,3组患儿FIQ、VIQ、PIQ及各分测验评分差异均无统计学意义(均P>0.05)。治疗后,OXC组算术、译码评分均高于LTG组(均P<0.05),与LEV组无差别(P>0.05);LTG组PIQ评分和分测验中填图、排图评分高于另外2组(均P<0.05);LEV组在词汇、理解、拼物评分高于另外2组(均P<0.05),译码评分高于LTG组(P<0.05),与OXC组无差别(P>0.05),VIQ和FIQ评分高于另外2组(均P<0.05)。(2)事件相关电位:①组内比较:LEV组治疗后潜伏期较前缩短(P<0.05),另外2组治疗前后差异均无统计学意义(均P>0.05)。②组间比较:治疗前,3组患儿P300波幅、潜伏期差异均无统计学意义(均P>0.05);治疗后,LEV组潜伏期较另外2组显著缩短(P<0.05),3组治疗前后波幅差异均�Objective To investigate the efficacy and cognitive function of 3 new antiepileptic drugs Oxcarbazepine(OXC),Lamotrigine(LTG)and Levetiracetam(LEV)in children with self-limited epilepsy with centrotemporal spikes(SeLECTS).Methods This was a prospective study.A total of 98 children with SeLECTS who were treated in the Second Affiliated Hospital of Xinxiang Medical University from January 2014 to June 2020 were divided into OXC group,LTG group and LEV group according to the applied therapeutic drugs.Video electroencephalograph(EEG),Wechsler Intelligence Scale for Children(WISC)and event-related potentials(ERPs)of the children were collected before treatment and 48 weeks of treatment.Clinical efficacy and impact on cognitive function among the 3 groups were compared.Results(1)Efficacy:There was no significant difference in the effective rate of seizure reduction after treatment among the 3 groups(χ^(2)=0.808,P=0.668).There was no significant difference in EEG remission rate among the 3 groups(χ^(2)=0.763,P=0.683).(2)Cognitive function:①Intragroup comparison of WISC findings showed that the full scale score(FIQ)and verbal intelligence quotient(VIQ)were significantly enhanced,and the scores of comprehension,vocabulary,arithmetic,decoding and spelling subtests were more significantly enhanced in OXC group after treatment(all P<0.05).In the LTG group,FIQ,VIQ and operational intelligence quotient(PIQ)were significantly enhanced after treatment(all P<0.05),and the subtest scores of comprehension,vocabulary,arithmetic,mapping and layout were significantly enhanced(all P<0.05).In LEV group,FIQ,VIQ and PIQ were significantly enhanced after treatment(all P<0.05),especially the increase in the VIQ,and the scores of vocabulary,understanding,similarity,arithmetic,decoding and puzzle subtests were significantly enhanced(all P<0.05).Pairwise comparison of WISC findings showed that there were no significant differences in the FIQ,VIQ,PIQ and subtest scores before treatment among the 3 groups(all P>0.05).After treatment,the arit

关 键 词：奥卡西平 拉莫三嗪 左乙拉西坦 伴中央-颞区棘波的自限性癫痫 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]