丙戊酸钠联合左乙拉西坦治疗小儿癫痫的疗效及对TLR4/NF-κB的影响

Effect of sodium valproate combined with levetiracetam on children with epilepsy and its effect on TLR4/NF-κB

目的:探讨丙戊酸钠联合左乙拉西坦治疗小儿癫痫脑损伤的临床疗效,及其对TLR4/NF-κB信号通路蛋白水平的改变。方法:选取本院2015年5月～2017年5月收治的120例小儿癫痫患者随机分为三组,丙戊酸钠组接受丙戊酸钠单独治疗,左乙拉西坦组接受左乙拉西坦单独治疗,联合组接受丙戊酸钠联合左乙拉西坦药物治疗半年,观察患者应用的药物疗效。采用酶联免疫吸附法检测患者治疗前后血清中通路蛋白(TLR4和NF-κB)和细胞因子(TNF-α、IL-Iβ和IL-6)的浓度变化。结果:丙戊酸钠联合左乙拉西坦治疗后,患者血清TLR4和NF-κB浓度、TNF-α、IL-Iβ和IL-6炎症因子水平明显升高,差异具有统计学意义(P <0. 05)。丙戊酸钠联合左乙拉西坦治疗治疗小儿癫痫的总有效率为95. 00%。结论:患者血清中TLR4/NF-κB信号通路相关蛋白的改变在临床诊断小儿癫痫的发生发展过程具有重要作用;丙戊酸钠联合左乙拉西坦治疗小儿癫痫脑损伤可能通过调节TLR4/NF-κB信号通路发挥作用。

Objective： To investigate the clinical efficacy of sodium valproate combined with levetiracetam in the treatment of brain injury in children with epilepsy and the changes in protein levels of TLR4/NF-κB signaling pathway. Methods： 120 patients with pediatric epilepsy were randomly divided into three groups： group Sodium valproate received sodium valproate alone,group Levetiracetam received levetiracetam alone combination group received sodium valerate and levetiracetaman drug treatment for six months to observe the efficacy of patients with drugs.（ TLR4 and NF-κB） and cytokines（ TNF-α,IL-Iβ and IL-6） in serum were measured by ELISA.Results： The levels of serum TLR4 and NF-κB,TNF-α,IL-Iβ and IL-6 were significantly increased after treatment with valproate combined with levetiracetam,the difference was statistically significant（ P 0. 05）. The total effective rate of valproate combined with levetiracetam in the treatment of pediatric epilepsy was 95. 00%.Conclusion： The changes of TLR4/NF-κB signaling pathway in serum of patients have an important role in the diagnosis and treatment of epilepsy in children. Sodium valproate combined with levetiracetam in the treatment of epilepsy in children may play a role by regulating the TLR4/NF-κB signaling pathway.