阿昔洛韦联合奥卡西平对单纯性疱疹病毒性脑炎伴癫痫患儿的疗效及安全性

Clinical efficacy and safety of acyclovir combined with oxcarbazepine in the treatment of children with herpes simplex encephalitis complicated with epilepsy

目的探究阿昔洛韦联合奥卡西平对单纯性疱疹病毒性脑炎伴癫痫患儿的临床疗效及安全性。方法将我院2014年7月至2018年9月收治的经临床确诊为单纯性疱疹病毒性脑炎伴癫痫的98例患儿随机分为对照组和观察组,每组49例。对照组给予阿昔洛韦联合左乙拉西坦口服液进行治疗,观察组给予阿昔洛韦联合奥卡西平口服混悬液进行治疗。对比分析两组患儿的临床有效率、血清NSE及炎性因子IL-1β、IL-6和TNF-α的表达、患儿的生活质量改善效果以及后遗症复发率。结果观察组患儿总有效率高于对照组(91.84%vs.65.31%,P<0.05)。观察组患儿治疗后血清NSE及炎性因子IL-1β、IL-6和TNF-α的表达较对照组患儿明显降低,差异有统计学意义(P<0.05)。观察组患儿的日常生活质量评分高于对照组(P<0.05)。此外,观察组患儿出现高热、颅内高压、意识障碍、抽搐和锥体外系反应等后遗症复发率低于对照组(6.12%vs.30.61%,P<0.05)。结论阿昔洛韦联合奥卡西平治疗单纯性疱疹病毒性脑炎伴癫痫患儿具有良好的临床疗效,可显著提升患儿的日常生活质量,降低患儿的后遗症复发率。

Objective To investigate the clinical efficacy and safety of aciclovir combined with oxcarbazepine in the treatment of children with herpes simplex encephalitis complicated with epilepsy.Methods A total of 98 pediatric patients with herpes simplex encephalitis complicated with epilepsy treated in our hospital from July 2014 to September 2018 were randomly divided into control group and observation group.Control group(n=49)was treated with acyclovir and levetiracetam oral solution,and observation group(n=49)was treated with acyclovir and oxcarbazepine oral suspension.The clinical efficacy,the expression of serum NSE and inflammatory factors IL-1β,IL-2,IL-6 and TNF-α,the improvement in the quality of life and the recurrence rate of the sequelae of the two groups were compared.Results The overall effective rate of children in observation group was higher than that in control group(91.84%vs.65.31%,P<0.05).The expression of serum NSE and inflammatory factors IL-1β,IL-6 and TNF-αin observation group was lower than that in control group(P<0.05).The scores of daily life quality in observation group were higher than those in control group(P<0.05).In addition,the recurrence rate of such sequelae as high fever,intracranial hypertension,disturbance of consciousness,convulsion and extrapyramidal reaction in observation group was lower than that in control group(6.12%vs.30.61%,P<0.05).Conclusion Acyclovir combined with oxcarbazepine is effective in the treatment of children with herpes simplex encephalitis with epilepsy,and it can significantly improve the quality of daily life in children and greatly reduce the recurrence rate of sequelae.