拉莫三嗪联合丙戊酸钠治疗儿童难治性癫痫的疗效及对电生理指标的影响  

Efficacy of lamotrigine combined with sodium valproate in the treatment of refractory epilepsy in children and its influence on electrophysiological indexes

作　　者：赖子梅 钟涛[1] Lai Zimei;Zhong Tao(Ganzhou People's Hospital,Ganzhou City,Jiangxi Province,341000,China)

机构地区：[1]赣州市人民医院,江西省赣州市341000

出　　处：《现代电生理学杂志》2024年第4期217-220,共4页Journal of Modern Electrophysiology

摘　　要：目的探究拉莫三嗪联合丙戊酸钠治疗儿童难治性癫痫的疗效及对电生理指标的影响。方法收集2021年8月至2023年9月赣州市人民医院收治的难治性癫痫患儿104例,年龄4~12岁,病程1~5年。采用随机数字表法将患儿分为对照组和观察组,每组52例。对照组单用丙戊酸钠治疗,观察组在对照组的基础上加用拉莫三嗪治疗,治疗持续6个月。比较两组临床疗效、电生理学指标、血清中枢神经特异性蛋白(S100β)、胶质纤维酸性蛋白(GFAP)及神经元特异性烯醇化酶(NSE)水平、癫痫发作情况及不良反应发生情况。结果观察组总有效率高于对照组(96.2%比80.8%,χ^(2)=6.029,P=0.014)。两组患儿治疗后P300波幅增大,潜伏期缩短(P<0.05),且观察组P300波幅比对照组高,潜伏期比对照组短(P<0.05);两组患儿癫痫样放电量及α波数量均减少(P<0.05),且观察组少于对照组(P<0.05)。治疗后两组患儿血清S100β、GFAP及NSE水平均降低,每月癫痫发作次数和发作持续时间均减少,且观察组低于对照组(P<0.001)。两组患儿不良反应总发生率比较差异无统计学意义(P=0.713)。结论拉莫三嗪与丙戊酸钠联合治疗难治性癫痫患儿,可调节其电生理学指标,减少癫痫发作频率,且用药安全性较高。Objective To explore the efficacy of lamotrigine combined with sodium valproate in the treatment of refractory epilepsy in children and its influence on electrophysiological indexes.Methods A total of 104 children with refractory epilepsy were collected from August 2021 to September 2023 in Ganzhou People's Hospital,aged 4 to 12 years,with a disease course of 1 to 5 years.The children were divided into control group and observation group by random number table,with 52 cases in each group.Patients were treated with sodium valproate alone in the control group,with lamotrigine combined with sodium valproate in the observation group for 6 months.The clinical efficacy,electrophysiological indexes,serum levels of central nervous specific protein(S100β),glial fibroacidic protein(GFAP)and neuron-specific enolase(NSE),seizures and adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group(96.2%vs.80.8%,χ^(2)=6.029,P=0.014).After treatment,the P300 amplitude increased and the latency shortened(P<0.05),and the P300 amplitude in the observation group was higher than that in the control group,and the latency was shorter than that in the control group(P<0.05).The amount of epileptic discharge andαwave in two groups were lower after treatment(P<0.05),and which were lower in the observation group than those in the control group(P<0.05).After treatment,serum levels of S100β,GFAP and NSE were decreased in both groups,and the number of seizures per month and duration of seizures were decreased,and which were lower in the observation group than those in the control group(P<0.001).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.713).Conclusion Lamotrigine combined with sodium valproate in the treatment of refractory epilepsy children can adjust electrophysiological indexes,reduce the frequency of seizures,and the drug is safe.

关 键 词：难治性癫痫 儿童 拉莫三嗪 丙戊酸 电生理学 

分 类 号：R742.1[医药卫生—神经病学与精神病学]