奥卡西平与左乙拉西坦治疗儿童良性癫痫伴中央-颞区棘波临床观察  

Clinical observation of oxcarbazepine and levetiracetam in the treatment of benign epilepsy in children with central-temporal spikes

作　　者：吕晓倩 苏红青 李婉慧 杜佩环 LYU Xiaoqian;SU Hongqing;LI Wanhui;DU Peihuan(Hengshui People’s Hospital,Hengshui 053000,China)

机构地区：[1]衡水市人民医院,河北衡水053000

出　　处：《中国实用神经疾病杂志》2024年第12期1533-1537,共5页Chinese Journal of Practical Nervous Diseases

基　　金：衡水市科技局项目(编号:2022014051Z)。

摘　　要：目的探讨奥卡西平与左乙拉西坦治疗儿童良性癫痫伴中央-颞区棘波(BECT)的疗效、安全性及对认知功能的影响。方法选取2019-05—2022-05就诊的BECT患儿200例作为研究对象,随机分为A组(奥卡西平治疗)和B组(左乙拉西坦治疗),各100例,以治疗3、6及12个月为观测时间点,对比2组临床疗效、脑电图(EEG)放电情况、药物不良反应及认知功能的改善情况。结果治疗3周期间,A组与B组因控制欠佳改变治疗方案退出者各2例,其余患儿继续接受治疗。治疗3、6及12个月后,A组总有效率(分别为93.88%、95.92%及97.96%)均高于B组(分别为84.69%、85.71%及90.82%)(P<0.05),A组EEG改善总有效率(分别为38.78%、39.80%及61.22%)均高于B组(分别为22.45%、25.51%及38.78%)(P<0.05)。2组药物不良反应总发生率差异无统计学意义(P>0.05)。治疗3、6及12个月后2组言语智商(VIQ)、操作智商(PIQ)和全智商(FIQ)评分相比治疗前均提升(P<0.05),2组VIQ、PIQ、FIQ评分差异无统计学意义(P>0.05)。结论左乙拉西坦、奥卡西平治疗儿童BECT的安全性均较高,两者对患儿认知功能的影响相当。相比左乙拉西坦,奥卡西平治疗BECT改善发作频率和EEG放电情况的效果更优,可作为治疗BECT的首选药物。Objective To investigate the efficacy and safety of oxcarbazepine and levetiracetam on children with benign epilepsy and centrotemporal spikes(BECT)and influence on cognitive function.Methods Totally 200 children with BECT from May 2019 to May 2022 were selected as the study subjects,and were randomly divided into group A(treated with oxcarbazepine)and group B(treated with levetiracetam),with 100 cases in each group.Treatment for 3,and 12 months were taken as observation time points to compare the clinical efficacy,electroencephalogram(EEG)discharge,adverse drug reactions and cognitive function improvement between the two groups.Results During 3 weeks of treatment,2 cases in group A and 2 cases in group B withdrew due to poor control,and the other children continued to receive treatment.After 3,6 and 12 months of treatment,the total effective rates of attack frequency improvement in group A(93.88%,95.92%and 97.96%)were higher than those in group B(84.69%,85.71 and 90.82%)(P<0.05),and the total effective rates of EEG improvement(38.78%,39.80%and 61.22%)were higher compared with those in group B(22.45%,25.51%and 38.78%)(P<0.05).The total incidence rates of adverse drug reactions revealed no statistical significance between both groups.After 3,6 and 12 months of treatment,the scores of verbal intelligence quotient(VIQ),performance intelligence quotient(PIQ)and full intelligence quotient(FIQ)in both groups were improved compared with those before treatment(P<0.05),but there were no statistical differences in the scores of VIQ,PIQ and FIQ between the two groups.Conclusion Levetiracetam and oxcarbazepine has high safety in the treatment of children with BECT,and their influence on cognitive function is similar.However,compared with levetiracetam,oxcarbazepine in the treatment of BECT has better effects on improving attack frequency and EEG discharge,so it can be used as the first choice for the treatment of BECT.

关 键 词：良性癫痫伴中央-颞区棘波 奥卡西平 左乙拉西坦 认知功能 安全性 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]