拉莫三嗪联合托吡酯治疗癫痫患儿的临床疗效及其对患者认知功能、神经因子水平的影响  

The Clinical Efficacy of Lamotrigine Combined with Topiramate in the Treatment of Children with Epilepsy and its Impact on Cognitive Function and Neurotrophic Factor Levels in Patients

作　　者：陈静 杨菊萍[1] 靳红光[1] 赵丹[1] CHEN Jing;YANG Juping;JIN Hongguang(The Second Hospital of Jiaozuo,Jiaozuo Henan 454000)

机构地区：[1]焦作市第二人民医院,河南焦作454000

出　　处：《医学临床研究》2024年第4期565-568,共4页Journal of Clinical Research

摘　　要：【目的】探讨拉莫三嗪联合托吡酯治疗癫痫患儿的临床疗效及其对患者认知功能、神经因子水平的影响。【方法】回顾性分析2021年2月至2022年12月本院收治的56例癫痫患儿的临床资料,根据治疗方案的不同将患儿分为对照组(拉莫三嗪治疗)、观察组(拉莫三嗪+托吡酯治疗),每组28例。比较两组临床疗效、脑电图疗效、治疗前及治疗后发作情况、神经因子[神经肽Y(NPY)、胰岛素样生长因子1(IGF-1)、脑源性神经营养因子(BDNF)、细胞间黏附分子-1(ICAM-1)]水平、认知功能[韦氏智力量表(WISC-Ⅳ)评分]、焦虑及抑郁情绪[汉密尔顿焦虑量表(HAMA)及抑郁量表(HAMD)评分]。【结果】观察组临床有效率、脑电图总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组发作频率及发作持续时间均少于治疗前,且观察组少于对照组,差异有统计学意义(P<0.05)。治疗后,观察组WISC-Ⅳ评分高于对照组,HAMA、HAMD评分低于对照组(P<0.05)。治疗后,两组血清NPY、IGF-1、BDNF、ICAM-1水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。【结论】拉莫三嗪联合托吡酯治疗小儿癫痫临床疗效较好,可减少发作次数,促进神经功能恢复,改善认知功能,缓解焦虑、抑郁情绪。【Objective】To explore the clinical efficacy of lamotrigine combined with topiramate in the treatment of children with epilepsy and its impact on cognitive function and neurotrophic factor levels in patients.【Methods】A retrospective analysis was conducted on the clinical data of 56 children with epilepsy admitted to our hospital from February 2021 to December 2022.According to different treatment plans,the children were divided into a control group(treated with lamotrigine)and an observation group(treated with lamotrigine and topiramate),with 28 cases in each group.Two groups were compared in terms of clinical efficacy,electroencephalogram efficacy,pre-treatment and post-treatment seizure status,neurokine levels[neuropeptide Y(NPY),insulin-like growth factor-1(IGF-1),brain-derived neurotrophic factor(BDNF),intercellular adhesion molecule-1(ICAM-1)],cognitive function[Wechsler Intelligence Scale(WISC-Ⅳ)score],anxiety and depression[Hamilton Anxiety Scale(HAMA)and Depression Scale(HAMD)score].【Results】The clinical effective rate and total effective rate of EEG in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the frequency and duration of seizures in both groups were lower than before treatment,and the observation group was lower than the control group,with a statistically significant difference(P<0.05).After treatment,the WISC-Ⅳscore of the observation group was higher than that of the control group,and the HAMA and HAMD scores were lower than those of the control group(P<0.05).After treatment,the serum levels of NPY,IGF-1,BDNF,and ICAM-1 in both groups were lower than before treatment,and the observation group was lower than the control group,with statistical significance(P<0.05).【Conclusion】The combination of lamotrigine and topiramate has a good clinical efficacy in the treatment of pediatric epilepsy,which can reduce the number of seizures,promote neurological function recovery,improve cognitive funct

关 键 词：癫痫/药物治疗 拉莫三嗪/药理学 托吡酯/药理学 认知 活化白细胞黏附分子 

分 类 号：R742.1[医药卫生—神经病学与精神病学]