左乙拉西坦治疗小儿癫痫的临床疗效及对血清IgA、IgM、IgG水平的影响

Clinical Efficacy of Levetiracetam in the Treatment of Pediatric Epilepsy and Its Effects on the Serum IgA, IgM and IgG Levels

目的:探讨左乙拉西坦用于治疗小儿癫痫的临床疗效及对血清IgA、IgM、IgG含量的影响。方法:选择2014年1月-2017年1月在我院就诊的癫痫患儿102例为研究对象,按治疗方式不同将其分为各51例患儿的观察组与对照组,观察组给予患儿左乙拉西坦片进行治疗,对照组给予患儿丙戊酸钠口服液进行治疗,两组患儿均治疗时间为24周。对比两组患儿的临床疗效、不良反应发生率、治疗前后血清IgA、IgM、IgG水平、认知功能评分和癫痫发作次数变化。结果:治疗后,观察组的总有效率96.09%(49/51)高于对照组84.31%(43/51)(P<0.05);两组患儿的IgA、IgM和IgG含量均比治疗前有所下降,且观察组IgA和IgM含量低于对照组(P<0.05),两组IgG含量无差异(P<0.05);观察组的不良反应发生率11.76%(6/51)低于对照组25.49%(13/51)(P<0.05);观察患儿的FIQ、PIQ和VIQ评分均比治疗前有所升高,对照组患儿的FIQ、PIQ和VIQ评分均比治疗前有所下降,观察组评分高于对照组(P<0.05);治疗后,两组各类型癫痫患儿的发作次数均比治疗前有所降低(P<0.05),且观察组各类型癫痫患儿的发作次数均明显少于对照组(P<0.05)。结论:左乙拉西坦治疗小儿癫痫的疗效显著,可显著降低癫痫患儿的血清免疫球蛋白水平,改善认知功能,降低癫痫的发作次数,且安全性较高。

Objective： To investigate the clinical efficacy of Levetiracetam in the treatment of pediatric epilepsy and its effects on the serum Ig A,Ig M and Ig G levels.Methods： 102 cases of epileptic children were selected from January 2014 to January 2017 in our hospital.According to the treatment,they were divided into the observation group and control group with 51 children in each group.The observation group was treated with Levetiracetam tablets.The control group was treated with Valproate oral liquid.Both groups were treated for 24 weeks.The clinical efficacy,changes of serum Ig A,Ig G,Ig G levels,cognitive function score before and after treatment,incidence of adverse reaction rate and seizures frequency were compared between the two groups.Results： The total effective rate of observation group was 96.09%（49/51）,which was significantly higher than that of the control group[84.31%（43/51）]（P〈0.05）.After treatment,the serum levels of Ig A,Ig M and Ig G in both groups were lower than those before treatment（P〈0.05）,At the same time,the serum levels of Ig A and Ig M in the observation group were lower than those in the control group（P〈0.05）,and there was no difference in serum level of Ig G between the two groups（P〈0.05）.The incidence rate of adverse reaction in observation group[11.76%（6/51）] was lower than that in the control group [25.49%（13/51）]（P〈0.05）.The FIQ,VIQ and PIQ score of observation group were increased than before treatment,which were decreased in the control group than those before treatment（P〈0.05）.After treatment,the times of seizures in both groups were lower than those before treatment（P〈0.05）,which was significantly lower in the observation group than that in the control group（P〈0.05）.Conclusions： Levetiracetam is remarkably effective in treating pediatric epilepsy,it can significantly reduce the serum immunoglobulin levels,improve the cognitive function,reduce the number of epileptic attack with high safety.