新型复方益生菌联合左乙拉西坦治疗难治性癫痫患儿的效果及对T淋巴细胞亚群、肠道菌群的影响  

Effect of Novel Compound Probiotics Combined with Levetiracetam in the Treatment of Children with Refractory Epilepsy and Their Impact on T Lymphocyte Subsets and Intestinal Flora

作　　者：岳明 郜广冉 刘俊英[3] YUE Ming;GAO Guangran;LIU Junying(Department of Neonatology,the Second Hospital of Handan City,Handan,Hebei 056001,China;Department of Pharmacy,the Second Hospital of Handan City,Handan,Hebei 056001,China;Department of Pediatrics,the First Hospital of Handan City,Handan,Hebei 056004,China)

机构地区：[1]邯郸市第二医院新生儿科,河北邯郸056001 [2]邯郸市第二医院药剂科,河北邯郸056001 [3]邯郸市第一医院儿科,河北邯郸056004

出　　处：《临床误诊误治》2025年第5期42-47,共6页Clinical Misdiagnosis & Mistherapy

基　　金：2022年度河北省医学科学研究课题计划(20220342)。

摘　　要：目的探究新型复方益生菌联合左乙拉西坦在难治性癫痫(IE)患儿中的治疗效果。方法选取2022年1月至2023年10月收治的112例IE患儿,应用随机数字表法分为2组各56例。对照组采用左乙拉西坦治疗,观察组采用新型复方益生菌联合左乙拉西坦治疗,均持续治疗24周。比较2组临床疗效、病情改善情况、不良反应,以及治疗前后认知功能状况[简易精神状态检查量表(MMSE)评分]、肠道菌群(大肠杆菌、双歧杆菌、乳酸菌、粪肠球菌)、T淋巴细胞亚群(CD3+、CD4+/CD8+、CD4+)、脑电图指标(α波、δ波、β波、θ波)。结果观察组治疗后总有效率为87.50%(49/56)高于对照组的71.43%(40/56),差异有统计学意义(P<0.05);2组治疗后癫痫发作频次、单次持续时间、癫痫样放电水平均低于或短于治疗前,MMSE评分高于治疗前,且观察组癫痫发作频次、单次持续时间较对照组低或短(P<0.05)。观察组治疗后乳酸菌、双歧杆菌菌落数均高于治疗前且高于对照组,大肠杆菌、粪肠球菌菌落数均低于治疗前且低于对照组(P<0.05,P<0.01)。治疗后观察组CD4+、CD3+、CD4+/CD8+水平均高于治疗前且高于对照组(P<0.05,P<0.01)。治疗后2组脑电图θ波均较治疗前低,且观察组更低(P<0.05)。治疗期间,2组总不良反应发生率比较差异无统计学意义(P>0.05)。结论新型复方益生菌联合左乙拉西坦治疗IE患儿效果确切,可通过调节患儿肠道菌群、改善免疫功能等途径达到控制患儿癫痫发作的目的,且不良反应少。Objective To explore the therapeutic effect of novel compound probiotics combined with Levetiracetam in children with refractory epilepsy(IE).Methods In total,112 children with IE treated from January 2022 to October 2023 were selected and divided into two groups with 56 patients in each group by random number table method.The control group was treated with Levetiracetam,and the observation group was treated with novel compound probiotics combined with Levetiracetam.Both groups were treated for 24 consecutive weeks.The clinical efficacy,condition improvement,adverse reactions,cognitive function status[Mini-Mental State Examination(MMSE)score],intestinal flora(Escherichia(E.)coli,Bifidobacterium,Lactobacillus,Enterococcus faecalis),T lymphocyte subsets(CD3+,CD4+/CD8+,CD4+),and electroencephalogram(EEG)indicators(αwave,δwave,βwave,θwave)before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 87.50%(49/56),which was higher than that of the control group[71.43%(40/56)],showing significant difference(P<0.05).After treatment,the seizure frequency,single duration and epileptiform discharge level in the two groups were lower or shorter than those before treatment,the MMSE score was higher than that before treatment,and seizure frequency and the single duration of the observation group were lower or shorter than those in the control group(P<0.05).After treatment,the colony number of Lactobacillus and Bifidobacterium in the observation group was higher than that before treatment and that in the control group,and the colony number of E.coli and Enterococcus faecalis was lower than that before treatment and that in the control group(P<0.05,P<0.01).After treatment,the levels of CD4+,CD3+and CD4+/CD8+in the observation group were higher than those before treatment and those in the control group(P<0.05,P<0.01).After treatment,θwave of EEG in the two groups was lower than that before treatment,and much lower in the observation group(P<0.05).During treatme

关 键 词：难治性癫痫 儿童 新型复方益生菌 左乙拉西坦 肠道菌群 CD3+ 脑电图 药物毒性 

分 类 号：R742.1[医药卫生—神经病学与精神病学]