免疫球蛋白联合抗癫痫药物对难治性癫痫患儿免疫球蛋白和T细胞亚群的影响

The Effects of Immunoglobulin Combined with Antiepileptic Drugs on Immunoglobulin and T Cell Subgroups in Children with Refractory Epilepsy

目的研究免疫球蛋白联合抗癫痫药物对难治性癫痫患儿免疫球蛋白和T细胞亚群的影响。方法以2014年1月至2016年12月我院收治的难治性癫痫患儿84例为观察对象。按照随机数字表法分为观察组和对照组各42例。对照组予以常规抗癫痫药物治疗,观察组则在对照组的基础上加用免疫球蛋白。分别对比治疗前后免疫球蛋白以及T淋巴细胞亚群变化情况,治疗前后癫痫发作频率以及不良反应发生情况。结果治疗后观察组患儿的Ig A、Ig G水平分别为1.0±0.2g/L、8.6±1.9g/L,均显著高于对照组的0.6±0.1g/L、5.8±1.3g/L;治疗后观察组患儿CD3+、CD4+、CD4+/CD8+水平分别为0.8±0.2、0.5±0.1、1.7±0.3,均显著高于对照组,而CD8+水平为0.2±0.0,显著低于对照组;治疗后3个月、6个月观察组患儿的癫痫发作频率分别为2.2±0.5次/周、1.4±0.3次/周,均显著低于对照组;以上差异均有统计学意义(P<0.05)。两组患儿腹胀、嗜睡以及胃痛发生率对比差异均无统计学意义(P>0.05)。结论免疫球蛋白联合抗癫痫药物可显著改善难治性癫痫患儿的免疫球蛋白和T细胞亚群水平,有效降低癫痫发作频率,安全性较好。

Objective To study the effects of immunoglobulin combined with antiepileptic drugs on immunoglobulin and T cell subgroups in children with refractory epilepsy. Methods From January 2014 to December 2016,84 cases with intractable epilepsy treated in our hospital were observed. According to the random number table method, the patients were divided into observation group and control group with 42 cases in each group. The children in the control group were treated with routine antiepileptic drugs, and the children in the observation group were treated with immunoglobulin on the basis of the control group. The changes in immunoglobulin and T lymphocyte subgroups were compared between, and the frequency of epileptic seizures and adverse reactions occurred before and after treatment. Results The observation group after treatment with levels of IgA, IgG, respectively was 1.0±0.2g/L, 8.6 ± 1.9g/L, were significantly higher than those of control group 0.6 ± 0.1g/L, 5.8 ± 1.3g/L; After treatment, in observation group, CD3＋ , CD4 ＋ , CD4＋/CD8＋ levels was 0.8 ±0.2,0.5 ± 0.1,1.7 ± 0.3 respectively, which were significantly higher than those of control group;CD8＋ level was 0.2 ± 0.1, which was significandy lower than the control group. 3 months and 6 months after treatment, epileptic seizure frequency of children in the observation group were 2.2 ± 0.5 times per week and 1.4 ± 0.3 times/week, which were significantly lower those in the control group（ P 〈 0.05 ）. The rate of abdominal distension, lethargy and stomachache in both groups were not significant （P 〉 0. 05 ）. Conclusion Treatment of immunoglobulin combined with antiepileptic drugsfor refractory epilepsy can significantly improve the level of immunoglobulin and T cell subgroups in children, and effectively reduce the incidence of epileptic seizures in children with good safety.