左乙拉西坦联合丙戊酸钠治疗儿童癫痫的效果及对神经和免疫功能的影响

Effect of levetiracetam combined with sodium valproate on epilepsy and its influence on neural and immune functions in children

目的探讨左乙拉西坦联合丙戊酸钠治疗儿童癫痫的效果及对神经、免疫功能的影响。方法抽取2018年1月至2021年12月郑州大学第五附属医院收治的癫痫患儿96例,按照随机数字表法分为研究组和对照组,每组48例。对照组采用丙戊酸钠治疗,研究组在对照组基础上采用左乙拉西坦治疗。比较两组的治疗效果,比较两组治疗前后血清神经损伤指标[神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、高迁移率族蛋白B1(HMGB1)]水平、免疫功能[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]及韦氏儿童智力量表[WLSC-CR,包含智商(FIQ)、操作智商(PIQ)、言语智商(VIQ)]评分,比较两组不良反应发生率。结果研究组总有效率(95.83%,46/48)高于对照组(77.08%,37/48),P<0.05。治疗后,研究组NSE、GFAP、HMGB1水平低于对照组(P<0.05),IgA、IgM、IgG水平低于对照组(P<0.05),FIQ、PIQ、VIQ评分高于对照组(P<0.05)。研究组不良反应发生率(4.17%,2/48)低于对照组(16.67%,8/48),P<0.05。结论左乙拉西坦联合丙戊酸钠治疗儿童癫痫疗效显著,还可明显改善神经、免疫功能,减轻机体神经损伤,提高患儿认知功能,且不良反应少,用药安全性较高。

Objective To investigate the effect of levetiracetam combined with sodium valproate in the treatment of epilepsy and its influence on neural and immune functions in children.Methods Ninety-six children with epilepsy treated in the Fifth Affiliated Hospital of Zhengzhou University from January 2018 to December 2021 were selected,and they were divided into the study group and the control group according to the random number table method,with 48 cases in each group.The control group was treated with sodium valproate,and the study group was treated with levetiracetam based on the treatment of the control group.The curative effect of the two groups were compared.The levels of serum nerve injury indicators,including neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP),high mobility group protein B1(HMGB1),immune function assessed by immunoglobulin A(IgA),immunoglobulin M(IgM)and immunoglobulin G(IgG),scores of Wechsler intelligence scale for children(WISC),including full intelligence quotient(FIQ),performance intelligence quotient(PIQ),verbal intelligence quotient(VIQ),were compared between the two groups before and after treatment.And the incidence of adverse reactions of the two groups were compared.Results The total effective rate of the study group(95.83%,46/48)was higher than that of the control group(77.08%,37/48),P<0.05.After treatment,the levels of NSE,GFAP and HMGB1 in the study group were lower than those in the control group(P<0.05),moreover,the levels of IgA,IgM and IgG in the study group were lower than those in the control group(P<0.05),however,the scores of FIQ,PIQ and VIQ in the study group were higher than those in the control group(P<0.05).The incidence of adverse reactions in the study group(4.17%,2/48)was lower than that in the control group(16.67%,8/48),P<0.05.Conclusions Levetiracetam combined with sodium valproate is effective in the treatment of epilepsy in children,and it can significantly improve neural and immune function,reduce the body’s nerve damage,improve the cognitive function of children,with less adverse reactions but high safety.