吡仑帕奈联合拉莫三嗪治疗局灶性癫痫患儿的疗效及对神经功能、癫痫发作频率的影响  

Therapeutic effect of combination therapy of pirenzapine and lamotrigine on children with focal epilepsy and its impact on neurological function and seizure frequency

作　　者：刘茸茸 苏琦 巨康璐 郭波 LIU Rong-rong;SU Qi;JU Kang-lu(Department of Pharmacy,Northwest Women and Children's Hospital,Xi'an Shaanxi 710000,China)

机构地区：[1]西北妇女儿童医院药剂科,陕西西安710000

出　　处：《临床和实验医学杂志》2025年第6期644-648,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研发计划项目(编号:2024SF-YBXM-312)。

摘　　要：目的探讨吡仑帕奈联合拉莫三嗪治疗局灶性癫痫患儿的疗效及对神经功能、癫痫发作频率的影响。方法前瞻性选取2022年5月至2024年5月西北妇女儿童医院收治的100例局灶性癫痫患儿作为研究对象,采用抽签法将其分为2组,即单药组(n=50)及联合组(n=50)。单药组采用拉莫三嗪治疗,起始剂量为100 mg/d,最大剂量400 mg/d,联合组在单药组的基础上增加吡仑帕奈治疗,起始剂量2 mg/d,维持剂量4~8 mg/d,两组患儿均连续治疗3个月。比较两组临床疗效,治疗前、治疗3个月后的简单部分及复杂部分癫痫发作频率、神经损伤指标[S-100β蛋白、胶质纤维酸性蛋白(GFAP)、髓鞘碱性蛋白质(MBP)]、神经递质指标[5-羟色胺(5-HT)、多巴胺、去甲肾上腺素(NE)]水平变化,并比较两组不良反应发生率。结果联合组总有效率为80.00%,高于单药组(58.00%),差异有统计学意义(P<0.05)。治疗3个月后,两组的癫痫简单部分发作次数、复杂部分发作次数均较治疗前减少,且联合组的癫痫简单部分发作、复杂部分发作次数分别为(6.23±1.36)、(4.14±0.81)次/月,均少于单药组[(8.78±2.22)、(7.17±1.11)次/月],差异均有统计学意义(P<0.05)。治疗3个月后,两组的S-100β蛋白、GFAP、MBP水平均较治疗前降低,且联合组的S-100β蛋白、GFAP、MBP水平分别为(0.63±0.12)μg/L、(2.12±0.31)ng/L、(6.93±1.13)μg/L,均低于单药组[(0.86±0.10)μg/L、(3.13±0.41)ng/L、(9.01±2.05)μg/L],差异均有统计学意义(P<0.05)。治疗3个月后,两组的5-HT、多巴胺、NE水平均较治疗前升高,且联合组的5-HT、多巴胺、NE水平分别为(430.56±52.11)、(318.36±36.25)、(98.93±6.13)μg/L,均高于单药组[(393.87±46.13)、(255.56±42.46)、(84.01±9.05)μg/L],差异均有统计学意义(P<0.05)。联合组与单药组不良反应总发生率分别为12.00%、8.00%,两组比较,差异无统计学意义(P>0.05)。结论吡仑帕奈联合拉莫三嗪治疗局灶性癫痫�Objective To investigate the therapeutic effect of pirenzapine combined with lamotrigine on children with focal epilepsy and its impact on neurological function and seizure frequency.Methods A total of 100 children with focal epilepsy admitted to Northwest Women and Children's Hospital from May 2022 to May 2024 were prospectively selected as the research objects.They were divided into the single drug group(n=50)and the combined group(n=50)according to the lottery.The single drug group was treated with lamotrigine,with an initial dose of 100 mg/d and a maximum dose of 400 mg/d.The combined group received additional treatment with pirenzapine on the basis of the single drug group,with an initial dose of 2 mg/d and a maintenance dose of 4-8 mg/d.Both groups of children were treated continuously for 3 months.The clinical efficacy of the two groups were compared;the seizure frequency in simple and complex epilepsy,the nerve damage indicators[S-100βprotein,glial fibrillary acidic protein(GFAP),myelin basic protein(MBP)],and neurotransmitter[5-hydroxytryptamine(5-HT),dopamine,norepinephrine(NE)]levels before and after 3 months of treatment were compared,and the incidence of adverse reactions was compared.Results The total effective rate of the combined group was 80.00%,which was higher than that of the single drug group(58.00%),and the difference was statistically significant(P<0.05).After 3 months of treatment,the number of simple partial seizures and complex partial seizures in the two groups were lower than those before treatment,and the number of simple partial seizures and complex partial seizures in the combined group were(6.23±1.36)and(4.14±0.81)times/month,respectively,which were less than those in the single drug group[(8.78±2.22)and(7.17±1.11)times/month],the differences were statistically significant(P<0.05).After 3 months of treatment,the levels of S-100βprotein,GFAP and MBP in the two groups were lower than those before treatment,and the levels of S-100βprotein,GFAP and MBP in the combined group were

关 键 词：癫痫 部分性 吡仑帕奈 拉莫三嗪 局灶性癫痫 神经功能 癫痫发作频率 不良反应 

分 类 号：R742.1[医药卫生—神经病学与精神病学]