托吡酯联合丙戊酸钠在小儿癫痫中的应用

Clinical application of topiramate combined with sodium valproate to treatment pediatric epilepsy

目的 探讨托吡酯联合丙戊酸钠治疗小儿癫痫的临床效果及对血清神经元特异性烯醇化酶(neuron-specificenolase,NSE)、中枢神经特异蛋白(protein S100β,S100β蛋白)的影响。方法 回顾性分析2020年5月至2022年5月浙江大学医学院附属第二医院临平院区儿科诊治的80例癫痫患儿,采用单盲法分为对照组和试验组各40例;对照组患儿采用托吡酯治疗,试验组采用托吡酯联合丙戊酸钠治疗,均连续用药12周;比较两组患儿的临床疗效、治疗前后癫痫样放电次数与癫痫发作频率、NSE、S100β蛋白水平及不良反应发生率。结果 治疗后,试验组患儿的临床总有效率高于对照组(Z=2.109,P=0.035);试验组患儿的癫痫样放电次数与癫痫发作频率低于对照组(P<0.001);试验组患儿的血清NSE、S100β蛋白水平低于对照组(P<0.001);两组的不良反应发生率比较,差异无统计学意义(P=0.499)。结论 托吡酯联合丙戊酸钠治疗小儿癫痫可改善患儿的临床症状与神经损伤状态,安全性好。

Objective To investigate the clinical application of topiramate combined with sodium valproate to treatment pediatric epilepsy and the effect of serum neuron-specificenolase(NSE)and protein S100β.Methods A retrospective study was performed on 80 children with epilepsy treated in the Department of Pediatrics,Linping District,the Second Affiliated Hospital of Medicine School,Zhejiang University from May 2020 to May 2022.According to single-blind method,80 cases were divided into control group and experimental group,each group with 40 cases.The control group was treated with topiramate,and the experimental group was treated with topiramate combined with sodium valproate for 12 consecutive weeks.The clinical efficacy,epileptic discharge times and seizure frequency,serum NSE and protein S100βlevels and adverse rate were compared between two groups before and after treatment.Results After treatment,the total clinical effective rate of experimental group was higher than that of control group(Z=2.109,P=0.035).The number of epileptic discharges and seizure frequency in experimental group were less than those in control group(P<0.001).The serum levels of NSE and protein S100βin experimental group were lower than those in control group(P<0.001).There was no significant difference in the incidence of adverse reactions between two groups(P=0.499).Conclusion Topiramate combined with sodium valproate in the treatment of pediatric epilepsy can improve the clinical symptoms and neurological damage status of children with epilepsy,and has good safety.