左乙拉西坦预防小儿热性惊厥复发的疗效分析

Analysis of the Efficacy of Levetiracetam in Preventing Recurrence of Febrile Convulsions in Children

目的:探讨左乙拉西坦(LEV)预防小儿热性惊厥(FS)复发的临床疗效。方法:选取2017年1月-2018年4月本院收治的FS患儿100例,按照随机数字表法分为研究组和对照组,各50例。对照组予以常规治疗,研究组在对照组基础上加以LEV治疗。比较两组患儿发热程度、S-100β蛋白(S-100β)、脑源性神经营养因子(BDNF)、血清神经元特异性烯醇化酶(NSE)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、CD4^+、CD8^+、CD4^+/CD8^+、行为能力评分、智力测试评分、复发情况及癫痫发生情况。结果:研究组患儿发热程度与对照组比较,差异无统计学意义(P>0.05)。干预后,两组S-100β、BDNF、NSE水平均低于干预前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。干预后,两组IgA、IgG、IgM及CD8^+均低于干预前,且研究组均低于对照组(P<0.05);干预后,两组CD4^+、CD4^+/CD8^+均高于干预前,且研究组均高于对照组(P<0.05);干预后,研究组智力测试评分高于干预前,且研究组高于对照组,差异均有统计学意义(P<0.05)。研究组复发率为12.00%,低于对照组的32.00%,差异有统计学意义(P<0.05);研究组癫痫发生率为4.00%,低于对照组的6.00%,差异无统计学意义(P>0.05)。结论:FS患儿联合LEV治疗,可显著降低患儿S-100β、BDNF、NSE水平,提高机体免疫力,有助于改善患儿的智商和行为能力,降低复发率。

Objective:To investigate the clinical effect of Levetiracetam (LEV) in preventing recurrence of febrile convulsion (FS) in children.Method:A total of 100 children with FS admitted to our hospital from January 2017 to April 2018 were selected.According to the random number table method,they were divided into study group and control group,50 cases in each group.The control group was given conventional treatment,the study group was treated with LEV on the basis of the control group.The fever degree,S-100β protein (S-100β),brain-derived neurotrophic factor (BDNF),serum neuron specific enolase (NSE),immunoglobulin G (IgG),immunoglobulin M (IgM),immunoglobulin A (IGA),CD4^+,CD8^+,CD4^+/CD8^+,behavioral ability score,intelligence test score,relapse and epilepsy incidence were compared between the two groups.Result:Compared with the control group,the difference was not statistically significant (P>0.05).After the intervention,S-100β,BDNF and NSE levels in both groups were lower than those before intervention,and the study group were lower than those of control group,the differences were statistically significant (P<0.05).After the intervention,IgA,IgG,IgM and CD8^+ in the two groups were all lower than those before intervention,and experimental group were lower than those of control group (P<0.05).After the intervention,CD4^+ and CD4^+/CD8^+ in both groups were higher than those before intervention,those of the experimental group were higher than those of control group (P<0.05).After the intervention,the intelligence scores of two groups were higher than those before the intervention,and the scores of study group was higher than that of the control group,the differences were statistically significant (P<0.05).The recurrence rate of the study group was 12.00%,lower than 32.00% in the control group,the difference was statistically significant (P<0.05).The incidence of epilepsy in the study group was 4.00%,lower than 6.00% in the control group,the difference was not statistically significant (P>0.05).Conclusion:Combined with LEV treatment,children with FS can significantly reduce S-100β,BDNF and NSE levels,improve immunity,improve intelligence and behavioral ability of children,and reduce recurrence rate.