丙戊酸钠联合拉莫三嗪治疗对癫痫患儿认知功能、免疫功能及神经损伤状态的影响

Effects of Sodium Valproate Combined with Lamotrigine on Cognitive Function,Immune Function and Neurological Damage of Children with Epilepsy

目的:探讨丙戊酸钠联合拉莫三嗪治疗对癫痫患儿认知功能、免疫功能及神经损伤状态的影响。方法:采用回顾性分析方法,选取2017年7月至2021年7月该院治疗的140例癫痫患儿的临床资料,根据干预方法分为对照组(n=70)和观察组(n=70)。对照组患儿采用丙戊酸钠治疗,观察组患儿在对照组基础上联合拉莫三嗪治疗,两组患儿均持续治疗3个月。治疗前后,检测并比较两组患儿的认知功能[简易精神状态检查量表(MMSE)评分]、焦虑情绪[焦虑自评量表(SAS)评分]、抑郁情绪[抑郁自评量表(SDS)评分]、免疫功能[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]、神经功能缺损程度[临床神经功能缺损程度评分量表(CSS)评分]、生活质量[健康调查简表(SF-36)评分]及不良事件发生情况。结果:治疗后,两组患儿的MMSE评分均较治疗前升高,SAS、SDS评分均较治疗前降低;且观察组患儿的MMSE评分高于对照组,SAS、SDS评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患儿的IgG、IgM水平均较治疗前降低,且观察组患儿的IgG、IgM水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患儿的CSS评分均较治疗前降低,且观察组患儿的CSS评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患儿的SF-36各项评分均升高,且观察组患儿的SF-36各项评分均高于对照组,差异均有统计学意义(P<0.05)。两组患儿不良反应总发生率的差异无统计学意义(P>0.05)。结论:丙戊酸钠联合拉莫三嗪治疗可有效改善癫痫患儿的认知功能、焦虑情绪和抑郁情绪,降低神经功能缺损评分,使患儿的近期感染得到控制、生活质量提高,且未明显增加不良反应。

OBJECTIVE:To probe into the effects of sodium valproate combined with lamotrigine on cognitive function,immune function and neurological damage of children with epilepsy.METHODS:Retrospective analysis was performed on clinical data of 140 children with epilepsy admitted into the hospital from Jul.2017 to Jul.2021,all children were extracted to be divided into the control group(n=70)and the observation group(n=70)according to the intervention method.The control group was treated with sodium valproate,while the observation group received lamotrigine on the basis of the control group.Both groups were treated with continuous treatment for 3 months.Before and after treatment,cognitive function[mini-mental state examination(MMSE)score],anxiety[self-rating anxiety scale(SAS)score],depression[self-rating depression scale(SDS)score],immune function[immunoglobulin G(IgG),immunoglobulin M(IgM)],degree of neurological impairment[clinical neurological impairment rating scale(CSS)score],quality of life[score of short form for health survey(SF-36)],and adverse drug reactions in two groups were detected and compared.RESULTS:After treatment,the MMSE scores of two groups were higher than those before treatment,and the SAS and SDS scores were lower than those before treatment;the MMSE scores of the observation group was higher than that of the control group,and the SAS and SDS scores were lower than those of the control group,with statistically significant differences(P<0.05).After treatment,the levels of IgG and IgM in two groups were lower than those before treatment,and the levels of IgG and IgM in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the CSS scores of two groups were lower than those before treatment,and the CSS scores of the observation group were lower than those of the control group,with statistically significant differences(P<0.05).After treatment,the SF-36 scores of two groups were higher than those before treatment,and the SF-36 scores of the observation group were higher than those of the control group,with statistically significant differences(P<0.05).There was no significant difference in the total incidence of adverse drug reactions between two groups(P>0.05).CONCLUSIONS:Sodium valproate combined with lamotrigine can effectively improve the cognitive function,anxiety and depression in children with epilepsy,reduce the neurological deficit score,control the recent infection and improve the quality of life in children,and does not increase the obvious adverse drug reactions.