左乙拉西坦联合托吡酯对难治性癫痫患儿的免疫功能以及认知功能的影响

Effects of levetiracetam combined with topiramate on immune function and cognitive function in children with refractory epilepsy

目的探讨左乙拉西坦联合托吡酯对难治性癫痫患儿免疫功能以及认知功能的影响。方法选取54例难治性癫痫患儿,随机分成对照组与联合组。均予原抗癫痫药物治疗方案,并积极预防并发症。对照组再予左乙拉西坦治疗,联合组在上述基础上再予托吡酯治疗,均治疗3个月。检测外周血T细胞亚群及免疫球蛋白水平。行脑电图分析,并评定认知功能,比较治疗效果。结果与治疗前比较,2组患儿CD3^+、CD4^+及CD4^+/CD8^+显著升高(P<0.05),CD8^+显著降低(P<0.05),血清IgA、IgG显著升高(P<0.05),IgM无显著变化(P>0.05),δ、α、β频段相对功率无显著变化(P>0.05),θ频段相对功率显著降低(P<0.05),视空间与执行能力、注意与集中、记忆力、计算与定向力及总分显著升高(P<0.05),命名、语言、抽象思维评分无显著变化(P>0.05)。与对照组比较,联合组患儿CD3^+、CD4^+及CD4^+/CD8^+较高(P<0.05),CD8^+较低(P<0.05),IgA、IgG较高(P<0.05),θ频段相对功率降低(P<0.05),视空间与执行能力、注意与集中、记忆力、计算与定向力及总分较高(P<0.05),总有效率较高(P<0.05)。结论左乙拉西坦联合托吡酯对少儿难治性癫痫疗效确切,可有效提高患儿免疫功能及认知功能。

Objective To investigate the effects of levetiracetam combined with on immune function and cognitive function in children with intractable epilepsy. Methods topiramate A total of 54 hospitalized children with intractable epilepsy were randomly divided into control group and combination group. All the children were treated with antiepileptic drugs, and the complications were prevented. The control group was treated with levetiracetam and the combination group was treated with topiramate. All the children were treated for 3 months. The levels of peripheral blood T lymphocyte subsets and immunoglobulin levels were detected by EEG analysis, and the cognitive function was evaluated. Results Compared with before treatment, levels of CD3^＋ , CD4^＋ and CD4^＋/CD8^＋ increased significantly in both groups （P 〈 0. 05 ） , CD8^＋ decreased significantly （P 〈 0.05 ） , and levels of serum IgA and IgG increased significantly （ P 〈 0.05 ）. There were no significant changes in IgM and relative power of 8, α and β bands （ P 〈 0.05 ）, and the relative power of the 0 band decreased （P 〈 0.05）. Visual space and executive ability, attention and concentration, memory, calculation and orientation, and total scores increased significant （ P 〈 0.05 ）, and scores of naming, language, abstract thinking did not change （P 〈 0.05）. Compared with the control group, levels of CD3^＋, CD4^＋ and CD4^＋/CD8^＋ in the combined group were significantly higher （P 〈 0.05 ）, CD8^ ＋ was significantly lower（P 〈 0.05 ）, levels of IgA, IgG were significantly higher（ P 〈 0.05 ）, relative power reduction of the 0 band were significantly lower（P 〈0.05 ）, and visual space and executive ability, attention and concentration, memory, calculation and orientation and total score were signif- icantly higher （ P 〈 0. 05 ）, and the total effective rate was significantly higher （ P 〈 0. 05 ）. Conclusion Levetiracetam combined with topiramate is effective in the treatment of intractable epilepsy in children, which can effectively improve the immune function and cognitive function.