拉莫三嗪联合大剂量地西泮治疗儿童良性癫痫伴中央颞区棘波合并睡眠中癫痫性电持续状态的临床效果  

The clinical effect of lamotrigine combined with high-dose diazepam in the treatment of benign epilepsy in children with central temporal spikes and epileptic electrical persistence during sleep

作　　者：陆琳 渠蕊 戴园园 LU Lin;QU Rui;DAI Yuanyuan(Department of Pediatric Neurology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院小儿神经内科,徐州221000

出　　处：《湖南师范大学学报（医学版）》2024年第4期93-96,105,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：江苏省妇幼健康科研项目“枸橼酸咖啡因联合亚低温对脑损伤早产儿S100B MMP-9水平的影响”(F202065)。

摘　　要：目的:评估拉莫三嗪联合大剂量地西泮治疗儿童良性癫痫伴中央颞区棘波(benign epilepsy with centrotemporal spikes,BECT)合并睡眠中癫痫性电持续状态(electrical status epilepticus during sleep,ESES)患儿的临床效果。方法:选取2019年1月—2023年2月徐州医科大学附属医院收治的80例BECT合并ESES患儿的临床资料,按随机数字表法分为对照组(拉莫三嗪治疗)和观察组(拉莫三嗪联合大剂量地西泮治疗)各40例,均治疗3个月。比较两组临床疗效、癫痫发作频次及持续时间、放电指数、脑电活动情况、操作智商(PIQ)、语言智商(VIQ)、全量表智商(FIQ)评分及血清标志物水平及不良反应发生情况。结果:观察组治疗总有效率高于对照组;观察组的癫痫发作频次少于对照组,持续时间短于对照组,痫样放电次数及累及导联数少于对照组,差异有统计学意义;治疗后,两组VIQ、PIQ和FIQ评分、脑电情况较治疗前升高,观察组PIQ、VIQ、FIQ、血清生物标志物水平高于对照组;差异有统计学意义;两组不良反应发生率比较无统计学意义。结论:拉莫三嗪联合大剂量地西泮治疗BECT合并ESES患儿可提高疗效,且安全性较高。Objective To evaluate the clinical efficacy of lamotrigine combined with high-dose diazepam in the treatment of benign epilepsy in children with central temporal spike wave (BECT) and status epilepticus during sleep (ESES).Methods Clinical data of 80 children with BECT combined with ESES admitted to Xuzhou Medical University Affiliated Hospital from January 2019 to February 2023 were selected.They were randomly divided into a control group (treated with lamotrigine) and an observation group (treated with lamotrigine combined with high-dose diazepam) using a random number table method,with 40 cases in each group.Both groups were treated for 3 months.Compare the clinical efficacy,frequency and duration of seizures,discharge index,EEG activity,PIQ,VIQ,FIQ scores,serum biomarker levels,and incidence of adverse reactions between two groups.Results The total effective rate of the observation group was higher than that of the control group;The frequency of epileptic seizures in the observation group was lower than that in the control group,and the duration was shorter than that in the control group.The number of epileptiform discharges and the number of involved leads were both lower than those in the control group,and the difference was statistically significant;The scores of VIQ,PIQ,and FIQ,as well as the EEG,improved in both groups compared to before treatment.The PIQ,PIQ,FIQ,and serum biomarker levels in the observation group were higher than those in the control group;The difference was statistically significant;There was no statistically significant difference in the incidence of adverse reactions between the two groups.Conclusion The combination of lamotrigine and high-dose diazepam can improve the efficacy and safety of BECT combined with ESES in children.

关 键 词：儿童中央颞区尖波良性癫痫 慢波睡眠期间电生理状态癫痫 拉莫三嗪 大剂量地西泮 

分 类 号：R748[医药卫生—神经病学与精神病学]