拉莫三嗪联合丙戊酸钠对癫痫患儿血脂指标及血清BDNF、NSE、S100β水平的影响

The effect of lamotrigine combined with sodium valproate on blood lipid indexes and serum BDNF, NSE and S100β levels in children with epilepsy

目的探讨拉莫三嗪联合丙戊酸钠对癫痫患儿血脂指标及血清脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、星形细胞钙结合蛋白(S100β)水平的影响。方法回顾性分析2016年1月至2019年12月徐州医科大学附属医院收治的80例癫痫患儿的临床资料,依据不同用药方案进行分组,单一组(40例)患儿予以丙戊酸钠治疗,联合组(40例)患儿在单一组治疗的基础上联合拉莫三嗪治疗,两组患儿均治疗3个月。比较两组患儿治疗后临床疗效、癫痫样放电减少率、不良反应;比较两组患儿治疗前后癫痫发作情况、血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、BDNF、NSE、S100β水平。结果联合组患儿临床总有效率与癫痫样放电减少率分别为97.50%、95.00%,显著高于单一组的80.00%、75.00%;与治疗前比,治疗后两组患儿癫痫发作频率、血清TC、TG、LDL、BDNF、NSE、S100β水平均显著降低,联合组显著低于单一组,两组患儿血清HDL、BDNF水平均显著升高,联合组显著高于单一组(均P <0.05);两组患儿发作持续时间均显著缩短,联合组显著短于单一组(均P<0.05);联合组患儿不良反应总发生率为7.50%,与单一组的10.00%相比,差异无统计学意义(P>0.05)。结论拉莫三嗪联合丙戊酸钠可有效改善癫痫患儿的癫痫发作情况,提高治疗疗效,降低血脂指标,保护脑神经功能,且不会增加不良反应。

Objective To investigate the effects of lamotrigine combined with sodium valproate on blood lipids, serum brain-derived neurotrophic factor(BDNF), neuron-specific enolase(NSE), and astrocyte calcium-binding protein(S100β) in children with epilepsy Level of influence. Methods The clinical data of 80 children with epilepsy admitted to the Affiliated Hospital of Xuzhou Medical University from January 2016 to December 2019 were retrospectively analyzed. The children were grouped according to the medication regimen. The children in a single group(40 cases) were treated with sodium valproate, combined Group(40 cases) children were treated with lamotrigine on the basis of single group treatment, and both groups were treated for 3 months. Compare the clinical efficacy, epileptiform discharge reduction rate, and adverse reactions between the two groups of children after treatment;compare the epileptic seizures, plasma total cholesterol(TC), glycyl triglyceride(TG), and low-density lipoprotein(LDL), high-density lipoprotein(HDL), BDNF, NSE, S100β levels. Results The total clinical effective rate and epileptiform discharge reduction rate of children in the combined group were 97.50% and 95.00%, respectively, which were significantly higher than the 80.00% and 75.00% of the single group;compared with before treatment, after treatment, the epileptic seizure frequency, plasma total cholesterol(TC), glycyl triglyceride(TG), low-density lipoprotein(LDL), BDNF, NSE, S100β of the two groups were all decreased, and the combination group was significantly Lower than the single group, the high density lipoprotein(HDL) and serum BDNF of the two groups of children increased, and the combination group was significantly higher than the single group(all P<0.05);the duration of onset of children in the two groups was shortened, and the combined group was significantly shorter than the single group(all P<0.05);the total incidence of adverse reactions in the combined group was 7.50%, which was not statistically significant compared with 10.00% in the single group(P>0.05). Conclusion Lamotrigine combined with sodium valproate can effectively improve the epileptic seizures of children with epilepsy, improve the therapeutic effect, reduce blood lipids, protect brain nerve function, and will not increase adverse reactions.