经颅磁刺激联合咪达唑仑对癫痫持续状态患儿脑单胺类神经介质的影响

Effects of transcranial magnetic stimulation combined with midazolam on monoamine neurotransmitters in children with status epilepticus

目的 探讨经颅磁刺激联合咪达唑仑对癫痫持续状态患儿脑单胺类神经介质的影响。方法 将150例癫痫持续状态患儿按照随机数字表法分为观察组和对照组。对照组采用咪达唑仑治疗。观察组在对照组基础上,给予经颅磁刺激治疗。比较两组的临床疗效。记录全部患儿的发作次数、持续时间、控制时间、意识正常时间。检测两组患者治疗前后血清中γ-氨基丁酸(GABA)、多巴胺(DA)、5-羟色胺(5-HT)的水平。运用癫痫持续状态严重程度量表(STESS)评估患者的癫痫程度。结果 观察组的疗效比对照组高,差异有统计学意义(P <0.05)。两组治疗后发作次数、持续时间明显降低(P <0.05);观察组治疗后的发作次数、持续时间、控制时间、意识正常时间比对照组低,差异有统计学意义(P <0.05)。两组治疗后的DA明显升高,GABA、5-HT明显降低(P <0.05);观察组治疗后的DA比对照组高,GABA、5-HT比对照组低,差异有统计学意义(P <0.05)。两组治疗后STESS评分明显降低,而观察组降低得更明显,差异有统计学意义(P <0.05)。结论 经颅磁刺激联合咪达唑仑治疗可提高癫痫持续状态的疗效,减轻患儿癫痫症状,可能与调节脑单胺类神经介质有关。

Objective To investigate the effect of transcranial magnetic stimulation combined with midazolam on monoamine neurotransmitters in children with status epilepticus.Methods 150 children with status epilepticus were divided into observation group and control group according to random number table.The control group was treated with midazolam.The observation group was treated with transcranial magnetic stimulation on the basis of the control group.The clinical effects of the two groups were compared.The attack times,duration,control time and consciousness normal time were recorded.The serum levels of GABA,DA and 5-HT were measured before and after treatment.The severity scale of status epilepticus(STESS)was used to evaluate the degree of epilepsy.Results the curative effect of the observation group was higher than that of the control group.The difference was statistically significant(P<0.05).The frequency and duration of attack in the two groups decreased significantly(P<0.05).The frequency,duration,control time and consciousness normal time of the observation group were lower than those of the control group.The difference was statistically significant(P<0.05).After treatment,DA was significantly increased,GABA and 5-HT were significantly decreased(P<0.05).The DA of the observation group was higher than that of the control group,and the GABA and 5-HT of the observation group were lower than that of the control group.The difference was statistically significant(P<0.05).After treatment,the STESS scores of the two groups decreased significantly.But the decrease of the observation group was more obvious.The difference was statistically significant(P<0.05).Conclusion Transcranial magnetic stimulation can improve the effect of status epilepticus and relieve the epileptic symptoms,which may be related to the regulation of brain monoamine neurotransmitters.