不同剂量左乙拉西坦短期应用防治小儿热性惊厥的效果及对脑电图的影响

Effectiveness of Different Doses of Levetiracetam in Short-term Application of Children with Febrile Convulsion and Its Effect on Electroencephalogram

目的探讨不同剂量左乙拉西坦短期应用防治小儿热性惊厥的效果及对患儿脑电图的影响。方法选择2016年6月—2018年4月我院收治的热性惊厥100例,按治疗方法法分为A组和B组,每组50例。2组均给予常规退热治疗,A组首日给予低剂量左乙拉西坦15 mg/kg治疗,B组首日给予高剂量左乙拉西坦30 mg/kg治疗。比较2组治疗效果,治疗前后患儿发热次数、热性惊厥复发率和次数、脑电图变化、血清神经元特异性烯醇化酶(NSE)及S-100β蛋白水平,记录不良反应发生情况。结果 2组总有效率、发热次数、热性惊厥复发率和复发次数、治疗后不同时间脑电图异常发生率比较差异均无统计学意义(P> 0. 05)。治疗后,2组血清NSE、S-100β水平较治疗前下降(P <0. 05),但2组间比较差异无统计学意义(P> 0. 05)。2组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论左乙拉西坦能有效防治小儿热性惊厥,减少脑电图异常,且低剂量与高剂量疗效相似。

Objective To investigate effectiveness of different doses of Levetiracetam in short-term application of children with febrile convulsion and its effect on electroencephalogram(EEG).Methods A total of 100 children with febrile convulsion admitted during June 2016 and April 2018 were divided into group A and B(n=50 in each group)according to therapeutic methods.All children were given conventional pyretolysis therapy,and then group A was treated with low dose(15 mg/kg)Levetiracetam on the first day,while group B was treated with high dose(30 mg/kg)Levetiracetam on the first day,and all treatments were maintained for 15 d.In two groups,therapeutic effectiveness,fevers frequency,recurrent numbers and frequency of febrile convulsions before and after treatment,EEG changes,serum neuron-specific enolase(NSE)and S-100βprotein levels were compared,and incidence rates of adverse reactions were recorded.Results There were no significant differences in total effective rate,fevers frequency,recurrent rate and frequency of febrile convulsions and incidence rates of EEG abnormalities at different times after treatment between two groups(P >0.05).After treatment in two groups,serum NSE and S-100βlevels were significantly decreased compared with those before treatment(P<0.05),but there were no significant differences in the above indexes between two groups(P >0.05).There was no significant difference in incidence rate of adverse reactions between two groups(P >0.05).Conclusion Levetiracetam may effectively prevent febrile convulsion in children and reduce incidence rate of EEG abnormalities,and low dose medication may achieve similar effectiveness with that by high dose medication.