托吡酯联合左乙拉西坦治疗儿童部分性癫痫发作的效果

Efficacy of topiramate combined with levetiracetam on partial seizures in children

目的探讨托吡酯联合左乙拉西坦治疗儿童部分性癫痫发作的效果。方法选取2021年1月至2022年9月驻马店市中心医院收治的80例部分性癫痫发作患儿为研究对象。根据随机数字表法分为对照组与观察组,每组40例。对照组给予托吡酯治疗,观察组在对照组基础上加用左乙拉西坦治疗,两组均持续治疗3个月。比较两组临床治疗效果、脑电图参数[α波减少>0.5 Hz、θ波增加、δ波增加]、血清生化指标[血清神经肽Y(NPY)、胶质纤维酸性蛋白(GFAP)、脑源性神经生长因子(BDNF)]及不良反应发生情况。结果治疗后,观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组α波减少>0.5 Hz、θ波增加、δ波增加比较差异未见统计学意义(P>0.05);治疗3个月时,观察组α波减少>0.5 Hz、θ波增加、δ波增加占比高于对照组(P<0.05)。治疗前,两组血清NPY、GFAP、BDNF比较差异未见统计学意义(P>0.05);治疗3个月时,两组血清NPY、GFAP、BDNF均较治疗前降低,且观察组低于对照组(P<0.05)。对照组不良反应发生率(10.00%,4/40)与观察组(12.50%,5/40)比较,差异未见统计学意义(χ^(2)=0.000,P=1.000>0.05)。结论托吡酯联合左乙拉西坦治疗可提高部分性癫痫发作患儿治疗效果,改善脑电图参数及血清生化指标,且安全性高。

Objective To investigate the efficacy of topiramate combined with levetiracetam on partial seizures in children.Methods Eighty children with partial epileptic seizures admitted to Zhumadian Central Hospital from January 2021 to September 2022 were selected as the research subjects.They were divided into a control group and an observation group according to the random number table method,with 40 cases in each group.The control group was treated with topiramate,and the observation group was treated with levetiracetam in addition to the control group.Both groups were treated continuously for 3 months.The clinical treatment and EEG parameters(α wave reduction>0.5 Hz,θ wave increase,δ wave increase),serum biochemical indicators[serum neuropeptide Y(NPY),glial fibrillary acidic protein(GFAP),brain-derived nerve growth factor(BDNF)],and the incidences of adverse reactions between the two groups were compared.Results After treatment,the total effective rate of the observation group was higher than that of the control group,and the difference was significant(P<0.05).Before treatment,there was no significant difference inαwave reduction>0.5 Hz,θ wave increase or δ wave increase(P>0.05).At 3 months of treatment,the proportion of α wave reduction>0.5 Hz,θ wave increase and δ wave increase in the observation group was higher than that of the control group(P<0.05).Before treatment,there was no significant difference in serum NPY,GFAP,or BDNF between the two groups(P>0.05).At 3 months of treatment,the serum levels of NPY,GFAP,and BDNF in both groups decreased compared to those before treatment,and those of the observation group were lower than those of the control group(P<0.05).The incidence of adverse reactions in the control group(10.00%,4/40)was not significantly different compared with the observation group(12.50%,5/40)(χ^(2)=0.000,P=1.00>0.05).Conclusions Topiramate combined with levetiracetam can improve the treatment effect,improve EEG parameters and serum biochemical indicators in children with partial epilepsy,and have high safety.