不同丙戊酸负荷量对癫痫持续状态的治疗效果分析

Analysis of the effect of valproic acid with different loading doses in treatment of children with status epilepticus

目的了解不同丙戊酸负荷量对癫痫持续状态患儿的治疗效果。方法收集2013年1月1日至2017年12月31日在浙江大学医学院附属儿童医院重症监护室住院治疗的癫痫持续状态患儿的病例资料,根据丙戊酸负荷量进行分组,了解各组患儿癫痫持续状态的控制情况。结果(1)66例癫痫持续状态患儿,包括癫痫36例(54.5%),颅内感染16例(24.2%),缺氧窒息3例(4.5%),颅内肿瘤2例(3.0%),脑发育异常2例(3.0%),颅内出血2例(3.0%),病因不明确5例(7.6%)。(2)所有癫痫持续状态患儿根据不同的丙戊酸负荷量(0 mg/kg,10~15 mg/kg,16~39 mg/kg,40 mg/kg)分为4组,各组间的性别、年龄差异无统计学意义,癫痫持续状态控制时间和癫痫控制情况差异无统计学意义(P=0.402、0.340)。(3)所有患儿予丙戊酸钠应用后都有监测肝功能,无一例患儿出现肝功能损害的表现。结论不同丙戊酸负荷量对于癫痫持续状态患儿的治疗效果无明显差异,并且接受负荷量为40 mg/kg治疗的癫痫持续状态患儿未出现相关不良反应。

Objective To explore the effect of valproic acid with different loading doses in treatment of children with status epilepticus.Methods The data of children who were hospitalized in the intensive care unit of the Children′s Hospital Affiliated to Zhejiang University because of status epilepticus from January 1,2013 to December 31,2017 were collected.All the patients were divided into different groups according to loading dose of valproic acid.The effect were analyzed in different groups.Results(1)There were 66 children with status epilepticus were admitted,including 35 males and 31 females.Among all children with status epilepticus,the etiology included epilepsy(n=36,54.5%),intracranial infection(n=16,24.2%),hypoxic asphyxia(n=3,4.5%),intracranial tumor(n=2,3.0%),abnormal brain development(n=2,3.0%),intracranial hemorrhage(n=2,3.0%),and etiology was not clear(n=5,7.6%).(2)All children with status epilepticus were divided into four groups according to different valproic acid loading dose(0 mg/kg,10-15 mg/kg,16-39 mg/kg,40 mg/kg).There are no significant differences in gender and age among groups.There were no significant differences in duration of status epilepticus and epileptic treatment efficiency(P=0.402,0.034).(3)All children were monitored for liver function after the treatment of sodium valproate,and no patient had been found increased alanine aminotransferase.Conclusion There are no significant differences in the effect of different valproic acid loading doses in children with status epilepticus,and no adverse side effects are observed in children with status epilepticus who received a dose of 40 mg/kg.