夜间大剂量丙戊酸钠对良性癫痫伴中央颞区棘波患儿痫样放电及认知功能的影响

The impact of higher-dose sodium valproate by night on epileptiform discharges and cognitive function in treatment of children with BECT

目的:探讨夜间大剂量丙戊酸钠对良性癫痫伴中央颞区棘波(BECT)患儿痫样放电及认知功能的影响。方法:选择78例良性癫痫伴中央颞区棘波患儿为研究对象,根据入院时间分为观察组和对照组各39例,两组患儿均给予丙戊酸钠夜间与清晨两次服用,对照组两次剂量相同,观察组则夜间剂量为清晨剂量的2倍;两组患儿疗程均为6个月,观察两组患儿脑电图改善情况、认知功能、临床疗效。结果:观察组有效率(84.62%)高于对照组(64.10%)(χ~2=4.304,P<0.05),异常脑电图患儿改善率(80.56%)高于对照组(58.82%)(χ~2=3.932,P<0.05);语言智商(VIQ)、操作智商(PIQ)、总智商(FIQ)评分均高于对照组(P<0.05),丙戊酸钠血药浓度高于对照组(t=2.864,P<0.05);两组患儿不良反应发生率比较差异无统计学意义(10.26%vs 15.38%,χ~2=0.459,P>0.05)。结论:夜间大剂量丙戊酸钠有助于更好地控制良性癫痫伴中央颞区棘波患儿痫样放电、改善认知功能,提高治疗效果。

Objective:To investigate the effects of higher-dose sodium valproate by night on epileptiform discharges and cognitive function in treatment of children with benign epilepsy with centro-temporal spikes(BECT).Methods:78 children with BECT were selected and divided into the experimental group(39 cases)and the control group(39 cases)according to the time of admission.With sodium valproate given twice at night and early in the morning,the posst meridiem(PM)dose was twice the ante meridiem(AM)dose in the experimental group,while the PM dose was equal to AM dose in the control group.Then the improvement of EEG,cognitive function and clinical curative effect were compared between the two groups in 6 months of treatment.Results:The efficiency of experimental group(84.62%)was significantly higher than that of the control group(64.10%)(χ2=4.304,P<0.05);The improvement rate of abnormal EEG(80.56%)was higher than that of the control group(58.82%)(χ2=3.932,P<0.05);Verbal Intelligence Quotient(VIQ),Performance Intelligence Quotient(PIQ)and Full-Scale Intelligence Quotient(FIQ)of the experimental group were significantly higher than those of the control group(t=3.468,3.924,3.912,P<0.05);Sodium valproate serum concentration in the experimental group was eminently higher than that of the control group(t=2.864,P<0.05);The difference in the rate of adverse effects between the two groups was not statistically significant(10.26%vs 15.38%)(χ2=0.459,P<0.05).Conclusions:Higher-dose sodium valproate by night in treatment of BECT can help take control of epileptiform discharges,and improve the cognitive function,and then improve the effect of therapy.