拉莫三嗪联合丙戊酸钠对小儿癫痫发作控制情况、发作频率、睡眠质量的影响

The Effects of Lamotrigine Combined with Sodium Valproate on Seizure Control,Seizure Frequency,and Sleep Quality in Children with Epilepsy

目的:分析拉莫三嗪联合丙戊酸钠对小儿癫痫发作控制情况、发作频率、睡眠质量的影响。方法:选取2021年3月至2023年3月福建省莆田学院附属医院收治的癫痫患儿30例作为研究对象,按照随机数字表法分为对照组和观察组,每组15例。对照组给予丙戊酸钠单一用药治疗,观察组给予拉莫三嗪与丙戊酸钠联合用药。比较2组患者的临床疗效,血清同型半胱氨酸(Hcy)、S-100β蛋白、神经元特异性烯醇化酶(NSE)水平、血清炎症介质水平、癫痫发作情况及脑电图结果,采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,并对2组患者的睡眠进行监测。结果:治疗后,观察组治疗总有效率显著优于对照组,观察组NSE、S-100β蛋白、Hcy、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-2、C-反应蛋白(CRP)水平均显著低于对照组,观察组癫痫发作频率、持续时间、放电次数均显著低于对照组,观察组PSQI评分显著低于对照组,观察组微觉醒指数、呼吸暂停指数显著低于对照组,观察组夜间最低血氧饱和度显著高于对照组,差异均有统计学意义(均P<0.05)。结论:拉莫三嗪+丙戊酸钠联合使用方案可有效改善癫痫患儿临床症状,并强化治疗效果,改善睡眠质量,适用于基层广泛推广。

Objective:To analyze the effects of lamotrigine combined with sodium valproate on seizure control,seizure frequency,and sleep quality in children with epilepsy.Methods:Thirty children with epilepsy admitted to the Affiliated Hospital of Putian University in Fujian Province from March 2021 to March 2023 were selected as the research subjects.They were randomly divided into a control group and an observation group using a random number table method,with 15 cases in each group.The control group was treated with sodium valproate monotherapy,while the observation group was treated with a combination of lamotrigine and sodium valproate.Compare the clinical efficacy of two groups of patients,including serum homocysteine(Hcy),S-100βprotein levels,neuron-specific enolase(NSE)levels,serum inflammatory mediator levels,seizure status,and EEG results.The Pittsburgh Sleep Quality Index(PSQI)was used to compare the changes in sleep quality between two groups of patients before and after intervention.The sleep of the two groups of patients was monitored.Results:After treatment,the total effective rate of the observation group was significantly better than that of the control group.The levels of NSE,S-100βprotein,Hcy,tumor necrosis factor-α(TNF-α),IL-6,IL-2,and C-reactive protein(CRP)in the observation group were significantly lower than those of the control group.The frequency,duration,and frequency of epileptic seizures in the observation group were significantly lower than those of the control group.The PSQI score in the observation group was significantly lower than that of the control group.The micro awakening index and apnea index in the observation group were significantly lower than those of the control group.The lowest blood oxygen saturation at night in the observation group was significantly higher than that of the control group.The differences between the two groups were statistically significant(P s<0.05).Conclusion:The combined use of lamotrigine and sodium valproate can effectively improve clinical symptoms in children with epilepsy,enhance treatment effectiveness,improve sleep quality,and is suitable for widespread promotion at the grassroots level.