左乙拉西坦联合氯硝西泮对局灶性癫痫患儿的疗效及骨代谢影响  

Efficacy of levetiracetam combined with clonazepam in treatment of focal epilepsy and its impact on bone metabolism in children

作　　者：唐华利 邓君 王菲 Tang Hua-li;Deng Jun;Wang Fei(Department of Pediatrics,Guilin Maternal and Child Health Hospital,Guilin 541001,China)

机构地区：[1]桂林市妇幼保健院儿科,桂林541001

出　　处：《中国药物应用与监测》2025年第1期9-12,共4页Chinese Journal of Drug Application and Monitoring

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20190240)。

摘　　要：目的分析左乙拉西坦联合氯硝西泮对局灶性癫痫患儿的疗效及骨代谢影响。方法选取桂林市妇幼保健院2022年7月至2024年6月治疗的局灶性癫痫患儿121例,根据治疗方法分为观察组63例和对照组58例。对照组接受左乙拉西坦单药治疗,观察组接受左乙拉西坦联合氯硝西泮治疗,治疗3个月。比较两组局灶性癫痫患儿的疗效、骨代谢、骨密度、癫痫发作情况以及不良反应的情况。结果治疗后,观察组总有效率较对照组高(93.65%vs 81.03%,χ^(2)=4.426,P<0.05)。治疗后,观察组患儿Ward三角区、腰椎、股骨颈的骨密度均较治疗前[分别是(0.44±0.04)g·cm^(-2) vs(0.54±0.06)g·cm^(-2)、(0.59±0.07)g·cm^(-2) vs(0.66±0.11)g·cm^(-2)、(0.55±0.11)g·cm^(-2) vs(0.63±0.12)g·cm^(-2)]下降(t=11.007、4.261、3.901,均P<0.05);对照组Ward三角区、腰椎、股骨颈的骨密度均较治疗前[分别是(0.42±0.05)g·cm^(-2) vs(0.53±0.04)g·cm^(-2)、(0.58±0.08)g·cm^(-2) vs(0.64±0.13)g·cm^(-2)、(0.53±0.10)g·cm^(-2) vs(0.62±0.15)g·cm^(-2)]下降(t=13.083、2.994、3.802,均P<0.05);治疗后,观察组患儿Ward三角区的骨密度较对照组[(0.44±0.04)g·cm^(-2) vs(0.42±0.05)g·cm^(-2)]高(t=2.439,P<0.05);治疗后,观察组癫痫发作次数和持续时间均少于对照组[(4.42±1.15)次·月^(-1) vs(3.04±1.24)次·月^(-1)、(6.58±1.58)min vs(5.21±1.37)min](P<0.05)。两组不良反应发生率(12.70%vs 12.07%),差异无统计学意义(χ^(2)=0.011,P>0.05)。结论左乙拉西坦联合氯硝西泮可以改善对局灶性癫痫患儿疗效、缩短癫痫持续时间以及降低发作次数且不会增加对患儿骨代谢产生的不良影响。Objective To investigate the efficacy of levetiracetam combined with clonazepam in treatment of focal epilepsy and its influence on bone metabolism in children.Methods A total of 121 children with focal epilepsy treated in Guilin Maternal and Child Health Hospital from July 2022 to June 2024 were selected as the research subjects and divided into the observation group(n=63)and the control group(n=58)according to the treatment method.The patients in the control group received levetiracetam monotherapy while those in the observation group received levetiracetam combined with clonazepam for 3 months.The therapeutic efficacy,bone metabolism,bone density,seizures and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of the observation group was higher than that of the control(93.65%vs 81.03%)(χ^(2)=4.426,P<0.05).In the observation group,the bone mineral density(BMD)of the Ward triangle,lumbar spine and femoral neck was lower than before treatment((0.44±0.04)g·cm^(-2)vs(0.54±0.06)g·cm^(-2),(0.59±0.07)g·cm^(-2)vs(0.66±0.11)g·cm^(-2),(0.55±0.11)g·cm^(-2)vs(0.63±0.12)g·cm^(-2))(t=11.007,4.261,3.901,all P<0.05).In the control group,the BMD of the Ward triangle,lumbar spine and femoral neck was also lower than before treatment((0.42±0.05)g·cm^(-2)vs(0.53±0.04)g·cm^(-2)(0.58±0.08)g·cm^(-2)vs(0.64±0.13)g·cm^(-2),(0.53±0.10)g·cm^(-2)vs(0.62±0.15)g·cm^(-2))(t=13.083,2.994,3.802,all P<0.05).The BMD of the Ward triangle was higher in the observation group than in the control((0.44±0.04)g·cm^(-2)vs(0.42±0.05)g·cm^(-2))(t=2.439,P<0.05).Meanwhile,the number and duration of epileptic seizures in the observation group were less than those in the control group after treatment((4.42±1.15)times per month vs(3.04±1.24)times per month,(6.58±1.58)min vs(5.21±1.37)min)(P<0.05).The difference in the incidence of adverse reactions was not statistically significant between the two groups(12.70%vs 12.07%)(χ^(2)=0.011,P>0.05).Conclusion Levetiracetam combined

关 键 词：左乙拉西坦 氯硝西泮 局灶性癫痫 疗效 骨代谢 

分 类 号：R742.1[医药卫生—神经病学与精神病学]