伊莱西胺联合西药治疗对癫痫患儿血清神经元特异性烯醇化酶的影响研究

Effect of Ilepcimide Combined Western Drugs on Serum Level of Neuron Specific Enolase in Treating Epilepsy Children Patients

目的观察应用胡椒碱衍生物伊来西胺添加治疗癫痫患儿血清特异性烯醇化酶(neuron specific enolase,NSE)水平变化。方法 107例癫痫患儿采用随机数字表法分为试验组(77例)及对照组(30例),对照组只采用抗癫痫西药治疗,试验在组抗癫痫西药的基础上加用伊莱西胺,初始剂量均为每日5mg/kg,分2次服用,发作未被控制的患儿给予逐渐加量,每周加量<每日10mg/kg。观察疗程为1年。治疗前、治疗0.5年以及治疗1年时行脑电图(EEG)检测,并采用电化学发光法检测血清NSE水平,治疗1年时进行癫痫疗效评估。结果治疗后试验组总有效率[65.0%(50/77)]高于对照组[30.0%(9/30)],差异有统计学意义(P<0.01)。与本组治疗前比较,试验组治疗0.5年及1年NES水平明显下降,且治疗1年NES水平低于治疗0.5年(P<0.05,P<0.01)。对照组各时间点及与试验之间比较,差异无统计学意义(P>0.05)。试验组治疗1年时EEG(3例正常范围EEG,5例界线性EEG,69例异常EEG)明显优于治疗前EEG(2例正常范围EEG,75例异常EEG)水平,差异有统计学意义(Z=-2.33,P<0.05);对照组30例患儿治疗前EEG(均为异常EEG)与治疗1年EEG(3例界线性EEG,27例异常EEG)比较,差异无统计学意义(Z=-1.732,P>0.05)。结论癫痫患儿添加胡椒碱衍生物治疗可以降低血清NSE水平,减少癫痫发作频度,脑电图得到改善。

Objective To observe changes of serum neuron specific enolase （NSE） level in children patients with epilepsy by additional use of ilepcimide （piperine derivative）. Methods Totally 107 epilepsy children patients were assigned to the test group （77 cases） and the control group （30 cases） according to random digit table. Children patients in the control group received anti-epileptic Western drugs only. Those in the test group additionally took ilepcimide, 5 mg/kg per day as initial dose, taken in two times. The dose was gradually added to those without control of epilepsy attack. Added dose within a week should not exceed 10 mg/kg per day. The therapeutic course for all was one year. Electroencephalo- gram （EEG） was performed before treatment, half a year after treatment, and one year after treatment, respectively. Serum NSE level was detected using electrochemiluminescence. Efficacy was assessed af- ter 1-year treatment. Results The total effective rate was 65.0% （50/77） in the test group, with statisti-cal difference as compared with that in the control group [30.0% （9/30）, P 〈0.01 1. Compared with before treatment, serum NES level obviously decreased in the test group after 0.5-year treatment and 1- year treatment respectively （P 〈0.05, P 〈0.01 ）. Besides, serum NES level was lower after 1-year treatment than after 0.5-year treatment （P 〈0.05, P 〈0.01 ）.There was no statistical difference in serum NES level between the test group and the control group at each time point （P 〉0.05）. Results of EEG were obviously superior in the test group （3 with normal range EEG, 5 critically abnormal EEG, 69 abnormal EEG） to the control group （2 with normal range EEG and 75 abnormal EEG） after 1-year treatment, with statistical difference （Z= -2.33, P 〈0.05）. There was no statistical difference in EEG results of the control group between before treatment （all abnormal EEG） and after 1-year treatment （3 critically abnormal EEG and 27 abnormal EEG） （Z= -1.732, P 〉0.05）. Conclusion Adding ilepcimide （piperine deriva- tive） for epilepsy children patients could lower serum NSE level and the frequency of seizures, and improve results of EEG.