左乙拉西坦预防复杂性热性惊厥的临床研究

Clinical study on preventing complex febrile seizures with prophylactic levetiracetam therapy

目的探究左乙拉西坦(Levetiracetam,LEV)预防复杂性热性惊厥复发的临床效果。方法纳入2017年1月—2020年1月在无锡市儿童医院就诊的100例复杂性热性惊厥患儿,随机分为观察组(50例,口服LEV治疗),其中男28例、女22例,平均年龄(1.57±0.42)岁;对照组(50例,口服地西泮治疗),其中男26例、女24例,平均年龄(1.58±0.39)岁。观察两组患儿治疗后的不良反应发生率、惊厥复发率、脑电图变化及神经发育情况。结果治疗后,观察组不良反应发生率为4.00%,对照组为18.00%,观察组不良反应发生率低于对照组,差异具有统计学意义(P<0.05);观察组复发率为2.00%,对照组复发率为14.00%,观察组复发率低于对照组,差异具有统计学意义(P<0.05);两组治疗后脑电图异常发生率均低于治疗前(P<0.05),但两组间无统计学差异(P>0.05);两组治疗前后神经发育评估结果均在正常范围,且无显著变化(P>0.05)。结论LEV治疗和预防复杂性热性惊厥复发方面效果显著,药物安全性高、不良反应少、促进预后改善。

Objective To explore the clinical efficacy of levetiracetam(LEV)in preventing recurrence of complex febrile seizures.Methods 100 children with complex febrile seizures who visited Wuxi Children’s Hospital from January 2017 to January 2020 were randomly divided into two groups,observation group(n=50,treated with oral LEV),including 28 males and 22 females,with an average age of(1.57±0.42)years;control group(n=50,treated with oral diazepam),including 26 males and 24 females,with an average age of(1.58±0.39)years.The incidence of adverse reactions,the recurrence rate,EEG changes and neural development after the treatment in both groups were observed.Results After treatment,the incidence of adverse reactions in the observation group was 4.00%,which was significantly lower(P<0.05)than that in the control group(18%).The recurrence rate of the observation group was 2.00%,which was significantly lower(P<0.05)than that in the control group(14%).The incidence of abnormal EEG in the two groups after treatment was lower than that before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The results of neurodevelopmental assessment in both two groups were in the normal range before and after treatment,and there was no significant change(P>0.05).Conclusions LEV is effective in the treatment and prevention of complex febrile seizures recurrence,with high safety,less adverse reactions and improved prognosis.