丙戊酸钠联合左乙拉西坦治疗癫痫患儿的剂量与疗效分析

Analysis of the effects and dose of sodium valproate combined with levetiracetam in the treatment of children with epilepsy

目的分析丙戊酸钠联合左乙拉西坦治疗癫痫患儿的应用剂量及疗效。方法随机数字法将150例癫痫患儿分为丙戊酸钠组、左乙拉西坦组与联合组(丙戊酸钠+左乙拉西坦),比较3组临床疗效、脑电图疗效、不良反应及治疗前后认知功能变化。结果联合组临床疗效、脑电图总有效率分别为94.00%、86.00%,较丙戊酸钠组的74.00%、62.00%差异有统计学意义(P<0.05);左乙拉西坦组脑电图总有效率80.00%,不良反应总发生率10.00%,较丙戊酸钠组的62.00%、32.00%差异有统计学意义(P<0.05);联合组、左乙拉西坦组治疗后P300潜伏期较治疗前、丙戊酸钠组治疗后比较差异有统计学意义(P<0.05),MoCA总分较丙戊酸钠组治疗后比较差异有统计学意义(P<0.05);联合组治疗后P300潜伏期明显低于左乙拉西坦组(P<0.05);联合组不良反应总发生率与其他两组比较差异无统计学意义(P>0.05)。结论丙戊酸钠联合左乙拉西坦相比两者单独用药治疗癫痫疗效更好,能明显改善患儿认知功能,且不增加药物不良反应,安全可行。

Objective To analyze the efficacy and dose of sodium valproate combined with levetiracetam in the treatment of children with epilepsy. Methods 150 children with epilepsy were divided into the sodium valproate group, levetiracetam group and combination group （sodium valproate combined with levetiracetam）. The clinical efficacy, EEG efficacy, adverse reactions and changes of cognitive function before and after treatment were compared among the groups. Results The clinical and EEG effective rates of the combination group were 94.00% and 86.00%, respectively. Com- pared with those in the sodium valproate group （74.00%, 62.00%）, there were significant differences （P〈 0.05）. The EEG ezfficacy, and total incidence rate of adverse reactions in the levetiracetam group were 80. 00% and 10. 00%, respec- tively. Compared with those in the sodium valproate group （62.00%, 32.00%）, there were significant differences （P 0.05）. After treatment, the P300 latency in the combination group and the levetiracetam group showed significant differ- ence from that before treatment and that in the sodium valproate group （P 〈 0.05）, and the total score of MoCA also showed significant difference （P 〈 0.05）. After treatment, the P300 latency in the combination group was significantly lower than that in the levetiracetam group （P 〈 0.05）, while the total incidence rate of adverse reactions showed no sig- nificant difference （P 〈 0.05）. Conclusion The effect of combination of sodium valproate and levetiracetam is better than monotherapy in the treatment of epilepsy. It can significantly improve the cognitive function of children, without in- creasing adverse drug reactions, safe and feasible.