不同常用抗癫痫药对儿童癫痫患者的影响及疗效  

作　　者：贾方增 陈文斌[1] 赵肖君[1] 刘俊[1] 张幸[1] 洪丽芳[1] 

机构地区：[1]浙江省台州市第二人民医院,317200

出　　处：《浙江临床医学》2024年第9期1342-1344,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省台州市科技计划项目(1902ky99)。

摘　　要：目的探讨常用抗癫痫药丙戊酸钠、左乙拉西坦、奥卡西平对儿童癫痫患者血清叶酸、同型半胱氨酸和血氨水平的影响以及疗效和副作用差异。方法选取2020年6月至2022年6月收治的儿童癫痫患者125例,根据治疗方式不同分为丙戊酸钠组(VPA组,45例)、左乙拉西坦组(LEV组,43例)和奥卡西平组(OXC组,37例),选取同期行健康体检儿童30例作为对照组。比较四组血清叶酸、血氨和同型半胱氨酸水平及三组治疗组的疗效和副作用。结果四组儿童入组时血清叶酸、血氨水平比较,差异有统计学意义(P<0.05)。三组治疗后血氨、同型半胱氨酸水平及治疗总有效率比较,差异有统计学意义(P<0.05)。结论临床治疗儿童癫痫患者考虑到疗效、治疗依从性、副作用和对代谢的影响可优选左乙拉西坦,在使用丙戊酸钠或奥卡西的情况下需关注患者血清叶酸、同型半胱氨酸和血氨水平的变化。Objective To investigate the effects of commonly used antiepileptic drugs sodium valproate,levetiracetam,and oxcarbazepine on serum folate,homocysteine,and blood ammonia levels,as well as the differences in efficacy and side effects in paediatric epilepsy patients.Methods 125 cases of paediatric epilepsy patients admitted from June 2020 to June 2022 were selected and divided into the sodium valproate group(VPA group,45 cases),the levetiracetam group(LEV group,43 cases)and the oxcarbazepine group(OXC group,37 cases)according to the treatment modality,and 30 cases of children who underwent a physical examination during the same period were selected as the control group.The serum folate,blood ammonia and homocysteine levels of the four groups were compared,as well as the efficacy and side effects of the three treatment groups.Results Comparison of serum folate and blood ammonia levels at the time of enrolment in the four groups of children showed statistically significant differences(P<0.05).Comparison of blood ammonia,homocysteine levels and total effective rate of treatment in the three treatment groups,the difference was statistically significant(P<0.05).Conclusion Clinical treatment of paediatric epilepsy patients considering the efficacy,treatment compliance,side effects and the impact on metabolism can be preferred to levetiracetam,in the case of the use of sodium valproate or oxcarbazepine need to pay attention to the changes in the patient's serum folic acid,homocysteine and blood ammonia levels.

关 键 词：癫痫 抗癫痫药 叶酸 同型半胱氨酸 血氨 

分 类 号：R742.1[医药卫生—神经病学与精神病学]