左乙拉西坦治疗小儿癫痫的效果及对认知功能的影响

Effect of Levetiracetam on epilepsy in children and its effect on cognitive function

目的探讨左乙拉西坦单药治疗小儿癫痫的效果与安全性及对认知功能的影响。方法选取2018年2月~2019年1月山西省儿童医院儿科和神经内科门诊收治的96例小儿癫痫患者为研究对象。按随机数字表法分为观察组和对照组,各48例。观察组给予左乙拉西坦片单药口服,对照组在此基础上联合服用奥卡西平,两组均干预16周。比较两组临床疗效、治疗前后脑电图改善效果,以及治疗期间不良反应发生情况,评估患儿认知功能。结果干预16周后,两组临床疗效和脑电图疗效评定比较,差异无统计学意义(P>0.05)。观察组不良反应发生率低于对照组(P<0.05)。两组治疗后中国修订韦氏儿童智力量表中操作智商(PIQ)、言语智商(VIQ)、全智商(FIQ)评分均较治疗前升高(均P<0.05);治疗后,观察组FIQ评分低于对照组,差异有统计学意义(P<0.05);两组治疗后PIQ、VIQ评分比较,差异无统计学意义(P>0.05)。结论采用左乙拉西坦单药治疗小儿癫痫与联用奥卡西平疗效相当,可有效改善临床症状,提高患儿的认知功能,降低不良反应发生率,安全性较高。

Objective To investigate the efficacy and safety of Levetiracetam in the treatment of epilepsy in children and its effect on cognitive function. Methods From February 2018 to January 2019, 96 pediatric epilepsy patients admitted to the Outpatient Department of Pediatrics and Neurology of Shanxi Children′s Hospital were selected as the study objects. According to the random number table method, the patients were divided into the observation group and the control group, each group with 48 cases. The observation group was given Levethracetam Tablets orally alone, the control group was given Oxazepine in combination on this basis. Both groups were treated for 16 weeks. Clinical efficacy, improvement of EEG before and after treatment, and occurrence of adverse reactions during treatment were compared between the two groups, and cognitive function of the children were evaluated. Results After 16 weeks of intervention, there was no statistically significant difference in clinical efficacy and EEG efficacy between two groups (P > 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05). Operational intelligence quotient (PIQ), verbal intelligence quotient (VIQ), and full intelligence quotient (FIQ) scores of the two groups were all increased after treatment (all P < 0.05). After treatment, FIQ score of the observation group was lower that of the control group (P < 0.05). There was no significant difference in PIQ and VIQ between the two groups after treatment (P > 0.05). Conclusion The treatment effect of Levetiracetam alone in children with epilepsy is equivalent to that of Ocasepine, which can effectively improve the clinical symptoms, enhance the cognitive function of children, reduce the incidence of adverse reactions, and is relatively safe.