小儿惊厥采用地西泮联合苯巴比妥治疗的临床效果研究

Study on clinical effect of diazepam combined with phenobarbital in children with convulsion

目的观察对惊厥患儿实施地西泮联合苯巴比妥治疗的临床效果。方法84例惊厥患儿,随机分为对照组和观察组,各42例。两组均给予常规治疗。在此基础上,对照组实行地西泮治疗,观察组实施地西泮联合苯巴比妥治疗。对比两组治疗效果、不良事件发生情况、治疗前后血清指标、预后情况及治疗后的免疫功能指标。结果观察组治疗总有效率95.24%高于对照组的80.95%(P<0.05)。治疗后,观察组脑源性神经营养因子(BDNF)(16.58±0.38)μg/L高于对照组的(12.26±1.05)μg/L,神经元特异性烯醇化酶(NSE)(20.01±2.09)ng/ml、中枢神经特异蛋白(S100-β)(0.15±0.01)μg/L低于对照组的(31.24±2.08)ng/ml、(0.29±0.02)μg/L(P<0.05)。观察组治疗6、12个月惊厥累积复发次数分别为(0.45±0.05)、(1.01±0.15)次,均低于对照组的(1.45±0.11)、(2.41±0.15)次(P<0.05)。观察组免疫球蛋白(Ig)A(0.82±0.07)g/L、IgM(0.61±0.10)g/L、IgG(6.11±0.48)g/L、CD8^(+)(0.20±0.01)均低于对照组的(0.90±0.10)g/L、(0.94±0.15)g/L、(7.84±0.42)g/L、(0.27±0.02),CD4^(+)(41.75±2.05)%、CD4^(+)/CD8^(+)(1.95±0.18)均高于对照组的(39.46±0.12)%、(1.75±0.14)(P<0.05)。观察组不良事件发生率略高于对照组,但差异无统计学意义(P>0.05)。结论对惊厥患儿实施地西泮联合苯巴比妥治疗,能够提升临床治疗效果,改善患儿的神经系统功能,提升药物治疗的安全性,值得推广。

Objective To observe the clinical effect of diazepam combined with phenobarbital in children with convulsion.Methods 84 children with convulsion were randomly divided into a control group and an observation group,with 42 cases in each group.Both groups were given conventional treatment.On this basis,the control group was treated with diazepam,and the observation group was treated with diazepam combined with phenobarbital.The therapeutic effect,occurrence of adverse events,serum indicators before and after treatment,prognosis and immune function indicators after treatment were compared between the two groups.Results The total effective rate of 95.24%in the observation group was higher than 80.95%in the control group(P<0.05).After treatment,the brain-derived neurotrophic factor(BDNF)of(16.58±0.38)μg/L in the observation group was higher than(12.26±1.05)μg/L in the control group;and NSE of(20.01±2.09)ng/ml and S100-βof(0.15±0.01)μg/L in the observation group were lower than(31.24±2.08)ng/ml and(0.29±0.02)μg/L in the control group(P<0.05).The cumulative frequency of convulsions in the observation group were(0.45±0.05)and(1.01±0.15)times after 6 and 12 months of treatment,which were lower than(1.45±0.11)and(2.41±0.15)times in the control group(P<0.05).The observation group had immunoglobulin(Ig)A of(0.82±0.07)g/L,IgM of(0.61±0.10)g/L,IgG of(6.11±0.48)g/L and CD8^(+) of(0.20±0.01)%,which were lower than(0.90±0.10)g/L,(0.94±0.15)g/L,(7.84±0.42)g/L and(0.27±0.02)%in the control group;and CD4^(+) of(41.75±2.05)%and CD4^(+)/CD8^(+)of(1.95±0.18)in the observation group were higher than(39.46±0.12)%and(1.75±0.14)in the control group(P<0.05).The incidence of adverse events in the observation group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion The implementation of diazepam combined with phenobarbital therapy in children with convulsion can improve the clinical therapeutic effect,improve the nervous system function of children,and enhance the safety of drug therapy,which is worthy of promotion.