托吡酯联合丙戊酸钠对小儿癫痫的临床疗效及血清leptin和APN水平变化的影响  

Effects of topiramate combined with sodium valproate on clinical efficacy and serum leptin and APN levels in children with epilepsy

作　　者：贾晓丹 朱彩花 张淼[1] JIA Xiao-dan;ZHU Cai-hua;ZHANG Miao(Department of Pediatric Neurology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院儿童神经内科,河南南阳473000

出　　处：《医药论坛杂志》2024年第14期1540-1543,共4页Journal of Medical Forum

摘　　要：目的分析小儿癫痫采用托吡酯联合丙戊酸钠治疗的临床疗效及对血清瘦素(leptin)和脂联素(adiponectin,APN)水平的影响。方法选取2020年1月—2022年8月南阳市中心医院儿童神经内科收治的60例小儿癫痫,根据用药不同分组,采用丙戊酸钠治疗的20例作为观察组;采用托吡酯治疗的20例作为对照组;采用丙戊酸钠联合托吡酯治疗的20例作为联合组,观察三组患儿的治疗临床效果、认知功能评分、血清leptin、APN水平以及用药后不良反应。结果联合组治疗后总有效率95.0%,高于观察组的65.0%和对照组的75.0%(χ^(2)=5.219、8.067,P<0.001);三组治疗前认知功能评分比较无统计学意义(P>0.05),治疗后三组均明显增加,且联合组总智商、操作智商和语言智商等认知功能评分为(102.11±3.94)分、(102.31±2.52)分及(99.41±2.63)分,明显高于观察和对照组(P均<0.05);三组治疗前leptin及APN水平比较无统计学意义(P>0.05),治疗后三组均明显改善,且联合组leptin水平(5.27±1.16)μg/mL,明显低于观察和对照组,APN水平(15.38±2.24)μg/mL,明显高于观察和对照组(P均<0.05);治疗后联合组不良反应发生率为15.0%,明显低于观察组的25.0%和对照组的30.0%(χ^(2)=2.351、3.324,P<0.001)。结论在三种治疗方法中,采用丙戊酸钠联合托吡酯治疗方法治疗效果最为显著,不良反应发生情况低于采用托吡酯治疗方法,可作为临床优选治疗方法推广。Objective To analyze the clinical efficacy of topiramate combined with sodium valproate in the treatment of epilepsy in children and its influence on the levels of serum leptin and adiponectin(APN).Methods Totally 60 cases of pediatric epilepsy admitted to the Department of Pediatric Neurology in Nanyang Central Hospital from January 2020 to August 2022 were selected.According to different drug groups,20 cases were treated with sodium valproate as the observation group;20 cases were treated with topiramate as control group;20 patients were treated with sodium valproate combined with topiramate as the combination group.The clinical effect,cognitive function score,serum leptin,APN levels and adverse reactions after medication in the three groups were observed.Results After treatment,the total effective rate of the combined group was 95.0%,which was significantly higher than 65.0% in the observation group and 75.0% in the control group(χ^(2)=5.219,8.067,P<0.001).There was no statistical significance in cognitive function scores of the three groups before treatment(P>0.05),and the total IQ,operational IQ and verbal IQ scores of the combined group were(102.11±3.94),(102.31±2.52)and(99.41±2.63)points.It was significantly higher than that in observation and control group(P<0.05).There was no significant difference in leptin and APN levels among the three groups before treatment(P>0.05),and leptin level of the combined group was(5.27±1.16)μg/mL,which was significantly lower than that of the observation and control group;APN level was(15.38±2.24)μg/mL,and it was higher significantly than that of the control and observation group(P<0.05).Treatment after,the adverse reactions incidence in group combination was 15.0%,lower significantly than that in observation group(25.0%)and control group(30.0%)(χ^(2)=2.351,3.324,P<0.001).Conclusion Among the three therapeutic methods,sodium valproate combined with topiramate has the most significant therapeutic effect,and the incidence of adverse reactions is lower than that of t

关 键 词：小儿癫痫 丙戊酸钠 托吡酯 临床效果 

分 类 号：R742.1[医药卫生—神经病学与精神病学]