丙戊酸钠联合左乙拉西坦治疗小儿难治性癫痫的临床效果  

Clinical efficacy of sodium valproate combined with levetiracetam in the treatment of intractable epilepsy in children

作　　者：林湘 LIN Xiang(Department of Neurology,Hengyang Central Hospital,Hunan Province,Hengyang 421001,China)

机构地区：[1]湖南省衡阳市中心医院神经内科,421001

出　　处：《临床合理用药杂志》2024年第17期33-36,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察丙戊酸钠联合左乙拉西坦治疗小儿难治性癫痫的临床效果。方法 选取2020年1月—2022年12月衡阳市中心医院收治的小儿难治性癫痫患儿80例,采用随机数字表法分为观察组和对照组,各40例。对照组单纯予左乙拉西坦口服溶液治疗,观察组在对照组基础上联合丙戊酸钠口服溶液治疗,2组均持续治疗12周。比较2组治疗效果,治疗前后血清学指标[胰岛素样生长因子-1(IGF-1)、中枢神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)]、认知功能评分(包括言语部分和操作部分)、生活质量评分及不良反应。结果 观察组患儿治疗总有效率为95.00%,高于对照组的77.50%(χ^(2)=5.165,P=0.023)。治疗12周后,2组IGF-1、S100β、NSE水平较治疗前降低,且观察组低于对照组(P均<0.01);2组认知功能—语言评分、认知功能—操作评分和生活质量评分均较治疗前提高,且观察组高于对照组(P均<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(12.50%vs.15.00%,χ^(2)=0.105,P=0.745)。结论 丙戊酸钠联合左乙拉西坦治疗小儿难治性癫痫的临床效果显著,可改善患儿血清学指标,利于认知功能发育,生活质量提升,且不会增加不良反应发生风险。Objective To observe the clinical efficacy of sodium valproate combined with levetiracetam in the treatment of intractable epilepsy in children.Methods Eighty children with intractable epilepsy admitted to Hengyang Central Hospital from January 2020 to December 2022 were selected.They were randomly divided into an observation group and a control group,with 40 cases in each group,using a random number table method.In the control group,levetiracetam oral solution was administered solely,while in the observation group,sodium valproate oral solution was combined with the treatment received by the control group.Both groups underwent continuous treatment for 12 weeks.Comparison of the treatment effects,comparison of changes in serum biomarkers(IGF-1,S100β,NSE),cognitive function scores(including verbal and operational components),changes in quality of life scores before and after treatment,and assessment of adverse reactions between the two groups.Results The total effective rate of treatment in the observation group was 95.00%,which was higher than the 77.50% in the control group(χ^(2)=5.165,P=0.023).After 12 weeks of treatment,the levels of IGF-1,S100β,and NSE decreased compared to before treatment in both groups,and those of the observation group was lower than the control group(P<0.01).The cognitive function(verbal and operational components) and quality of life scores in both groups improved compared to before treatment,and those of the observation group was higher than the control group(P<0.01).There was no statistically significant difference in the overall incidence of adverse reactions between the observation group and the control group(12.50% vs.15.00%,χ^(2)=0.105,P=0.745).Conclusion The clinical efficacy of sodium valproate combined with levetiracetam in the treatment of intractable epilepsy in children is significant.It can improve serum biomarkers,promote the development of cognitive function,enhance the quality of life in children,and does not increase the risk of adverse reactions.

关 键 词：小儿难治性癫痫 丙戊酸钠 左乙拉西坦 治疗效果 

分 类 号：R742.1[医药卫生—神经病学与精神病学]