左乙拉西坦治疗儿童良性癫痫伴中央颞区棘波合并睡眠中癫痫性电持续状态的临床效果及对放电指数的影响

Clinical effect of levetiracetam on children with BECT and ESES and its influence on discharge index

目的 探讨左乙拉西坦治疗儿童良性癫痫伴中央颞区棘波(BECT)合并睡眠中癫痫性电持续状态(ESES)的临床效果及对放电指数的影响。方法 选取2019年8月—2021年8月广西医科大学第一附属医院收治的98例BECT合并ESES患儿,根据随机数字表法分为研究组和对照组,每组49例。对照组采用奥卡西平片和丙戊酸钠口服溶液治疗,研究组在对照组的基础上给予左乙拉西坦治疗。比较两组患儿的癫痫发作频次、症状持续时间、放电指数、棘波指数、临床疗效、脑电活动情况、操作智商(PIQ)评分、语言智商(VIQ)评分、全量表智商(FIQ)评分及不良反应。结果 研究组的癫痫发作频次少于对照组,症状持续时间均短于对照组(P <0.05);研究组治疗前后放电指数差值高于对照组(P <0.05);研究组总有效率高于对照组(P <0.05);研究组治疗前后α波段、β波段、θ波段、δ波段差值均高于对照组(P <0.05);研究组治疗前后PIQ、VIQ、FIQ评分差值均高于对照组(P <0.05);研究组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论 左乙拉西坦用于治疗BECT合并ESES可以改善临床症状,疗效确切,同时可以改善放电指数和认知功能,安全可靠。

Objective To explore the clinical effect of levetiracetam on the treatment of benign childhood epilepsy with centro-temporal spike(BECT)and electrical status epilepticus during sleep(ESES)in children and its influence on discharge index.Methods Ninety eight children with BECT and ESES admitted to the First Affiliated Hospital of Guangxi Medical University from August 2019 to August 2021 were randomly divided into the study group(n=49)and the control group(n=49).The control group was treated with oxcarbazepine tablets and sodium valproate,and the study group was treated with levetiracetam on the basis of the control group.The frequency of seizures,duration of symptoms,discharge index,spike wave index,clinical efficacy,brain electrical activity,perational intelligence quotient(PIQ),verbal intelligence quotient(VIQ),full scale intelligence quotient(FIQ)scores,and adverse reactions were compared in both groups.Results The frequency of seizures and duration of symptoms in the study group were lower than the control group(P<0.05).The difference of discharge index in the study group before and after treatment was higher than the control group(P<0.05).The total effective rate of the study group was higher than the control group(P<0.05).The difference ofαband,βbandθ,bandδin the study group before and after treatment was higher than the control group(P<0.05).The difference of PIQ,VIQ,and FIQ scores in the study group before and after treatment was higher than the control group(P<0.05).There was no difference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion Levetiracetam can be used to treat children with BECT and ESES.It can improve clinical symptoms with definite effect,as well as discharge index and cognitive function,and it is safe and reliable.