左乙拉西坦联合奥卡西平治疗小儿难治性癫痫的临床研究  

Clinical Study on the Combination of Levetiracetam and Oxcarbazepine in the Treatment of Childhood Refractory Epilepsy

作　　者：裴铮[1] 陈娴 PEI Zheng;CHEN Xian(Department of Pediatric Neurology,Guangdong Maternal and Child Health Hospital,Guangzhou Guangdong 511400,China;Operation Room,Guangdong Maternal and Child Health Hospital,Guangzhou Guangdong 511400,China)

机构地区：[1]广东省妇幼保健院小儿神经内科,广东广州511400 [2]广东省妇幼保健院手术室,广东广州511400

出　　处：《中国卫生标准管理》2024年第23期139-142,共4页China Health Standard Management

摘　　要：目的探讨左乙拉西坦联合奥卡西平治疗小儿难治性癫痫(childhood refractory epilepsy,CRE)的临床效果。方法回顾性分析2022年1月—2024年1月广东省妇幼保健院收治的68例CRE的临床资料,根据治疗方法不同分为对照组与观察组,各34例。对照组予奥卡西平治疗,观察组联合左乙拉西坦治疗。疗程结束后评估疗效、临床症状、血清学指标、生活质量与安全性。结果观察组治疗总有效率为94.12%(32/34),高于对照组的76.47%(26/34),差异有统计学意义(P<0.05)。治疗后,观察组癫痫发作频率为1.00(1.00,1.00)次/月,低于对照组的2.00(1.00,2.00)次/月,观察组癫痫发作持续时间为(4.71±1.22)min/次,短于对照组的(8.29±2.06)min/次,差异有统计学意义(P<0.05)。观察组血清神经元特异性烯醇化酶(neuron sepecific enolase,NSE)、白细胞介素-6(interleukin,IL-6)水平分别为(9.30±1.73)μg/L、(3.44±0.74)pg/mL,低于对照组的(14.50±2.55)μg/L、(7.03±1.35)pg/mL,差异有统计学意义(P<0.05)。观察组儿童癫痫生活质量量表(quality of life childhood epilepsy,QOLCE)评分为(82.30±6.05)分,高于对照组的(76.70±7.51)分,差异有统计学意义(P<0.05)。2组患儿均未出现严重不良反应,未影响治疗方案的继续执行。结论左乙拉西坦联合奥卡西平治疗CRE疗效优于奥卡西平单药治疗,能够显著改善患儿临床症状,降低NSE、IL-6水平,提升患儿的生活质量,安全性高。Objective To explore the clinical efficacy of the combination of levetiracetam and oxcarbazepine in the management of childhood refractory epilepsyy(CRE).Methods Clinical data of 68 cases of CRE admitted to Guangdong Maternal and Child Health Hospital from January 2022 to January 2024 were retrospectively analyzed.Accorded to different treatment methods,they were divided into control group and observation group,with 34 cases in each group.The control group was treated with oxcarbazepine,the observation group was treated with levetiracetam in combination.The therapeutic efficacy,clinical symptoms,serological indicators,quality of life,and safety were evaluated after the treatment course.Results The total effective rate of the observation group was 94.12%(32/34),which was higher than 76.47%(26/34)of the control group,and the difference was statistically significant(P<0.05).After treatment,the seizure frequency of the observation group was 1.00(1.00,1.00)times/month,which was lower than 2.00(1.00,2.00)times/month of the control group,and the seizure duration of the observation group was(4.71±1.22)min/times,which was shorter than(8.29±2.06)min/times of the control group,the differences were statistically significant(P<0.05).Serum neuron specific enolase(NSE)and interleukin-6(IL-6)levels in the observation group were(9.30±1.73)μg/L and(3.44±0.74)pg/mL,respectively,which were lower than(14.50±2.55)μg/L and(7.03±1.35)pg/mL of control group,and the differences were statistically significant(P<0.05).The score of quality of life childhood epilepsy(QOLCE)in the observation group was(82.30±6.05)points,which was higher than(76.70±7.51)points in the control group,and the difference was statistically significant(P<0.05).No serious adverse reactions occurred in the two groups,which did not affect the continuation of the treatment regimen.Conclusion The efficacy of levetiracetam combined with oxcarbazepine in treating CRE is superior to the monotherapy of oxcarbazepine.It can significantly ameliorate the clinical sympto

关 键 词：小儿难治性癫痫 奥卡西平 左乙拉西坦 疗效 神经元特异性烯醇化酶 白细胞介素 生活质量 

分 类 号：R741[医药卫生—神经病学与精神病学]