左乙拉西坦联合托吡酯治疗Lennox-Gastaut综合征疗效观察

Therapeutic Effect of Levetiracetam Combined with Topiramate on Lennox-gastaut Syndrome

目的观察左乙拉西坦联合托吡酯治疗儿童难治性癫痫综合征的临床效果。方法选取我院2015年6月~2017年12月收治的儿童难治性癫痫综合征患儿40例,采取数字随机表法分为治疗组与对照组,每组20例。治疗组患儿给予左乙拉西坦联合托吡酯干预,对照组患儿给予左乙拉西坦单药干预,治疗8周后比较两组患儿的临床疗效。比较治疗组前后患儿头颅磁共振波谱、脑电图棘慢波指数的变化,同时采用中国修订版韦氏儿童智力量表(WISC-R)作为评定工具,对治疗组前后儿童进行智力测试及评定。结果治疗组临床有效率为90.00%,高于对照组60.00%,统计学意义显著(P<0.01)。治疗组患儿头颅磁共振波谱NAA(N-乙酰天门冬氨酸)峰值升高,脑电图棘慢波指数较治疗前减少,患儿认知功能改善,统计学意义显著(P<0.01)。结论治疗能够降低脑电图棘慢波指数、提升NAA/Cho+Cr、NAA/Cho及NAA/Cr比值,改善患儿认知功能,临床疗效显著,为临床提供参考。

Objective To observe the clinical effect of levetiracetam combined with topiramate in the treatment of refractory epilepsy syndrome in children.Methods A total of 40 children with refractory epilepsy syndrome admitted to our hospital from June 2015 to December 2017 were enrolled.The patients were divided into treatment group and control group by digital random table method,20 cases in each group.The patients in the treatment group were treated with levetiracetam plus topiramate,and the children in the control group were given levetiracetam alone.After 8 weeks of treatment,the clinical effects of the two groups were compared.The changes of head magnetic resonance spectroscopy and EEG spine slow wave index were compared before and after treatment.The Chinese version of Wechschild Intelligence Scale（WISC-R）was used as the assessment tool to test the intelligence of children before and after treatment. assessment.Results The clinical effective rate of the treatment group was 90.00%,which was higher than that of the control group 60.00%,the statistical significance was significant（P〈0.01）.The peak value of brain magnetic resonance spectroscopy NAA（N-acetylaspartate）increased,the spike-slow wave index of electroencephalogram decreased,the cognitive function of the children improved,the statistical significance was significant（P〈0.01）.Conclusion Treatment can reduce the electroencephalogram slow wave index,improve the ratio of NAA/Cho＋Cr,NAA/Cho and NAA/Cr,improve the cognitive function of children,and have clinical curative effect,which provides a reference for clinical.