Objective:To explore the effects of sodium valproate combined with levetiracetam in the treatment of children epilepsy,and its influences on serum S-100βand high mobility group box-1(HMGB-1)in children with epilepsy....Objective:To explore the effects of sodium valproate combined with levetiracetam in the treatment of children epilepsy,and its influences on serum S-100βand high mobility group box-1(HMGB-1)in children with epilepsy.Methods:A total of 160 children who were diagnosed as epilepsy in Baogang Hospital of Inner Mongolia from July 2016 to October 2018 were selected as research objects.They were randomly divided into the study group(n=80)and the control group(n=80)by the random number table method,i.e.,they were treated with sodium valproate combined with levetiracetam and sodium valproate alone,respectively.After 16 weeks of treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge were evaluated,and chi-square test was used for statistical comparison.The related indicators,including serum tumor necrosis factor-(TNF-α),hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),haematocrit(HCT),erythrocyte sedimentation rate(ESR),serum S-100βand HMGB-1,were measured before and after treatment.Paired t-test was used for the comparison in the above indicators within a group before and after treatment;group t-test was used for the comparison between two groups.Chi-square test was used for the comparison in the rate of adverse reactions during treatment between two groups.The study was approved by Ethics Committee of Baogang Hospital(Approval No.:BG201606073),and all children’s guardians were required to sign informed consent forms for clinical study.There were no statistically significant differences between two groups in general clinical data(p>0.05),such as sex constituent ratio,age,the course of disease,the frequency of epileptic seizure per year before treatment,the incidence of epileptiform discharge before treatment and the constituent ratio of types of epileptic seizure,etc.Results:1)After treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge in the study group were 92.5%(74/80)and 85.0%(68/80)respectively,which were both significantly higher than those in the control group[68.8%(55/80)and 58.8%(47/80)],and the differences were statistically significant(Х^(2)=14.444,13.635;p<0.001).2)In the study group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(53.1±14.0)pg/ml,(5.0±2.5)mg/L,(12.5±3.1)μmol/L,(38.1±5.1)%and(3.0±0.5)mm/h respectively,which were all significantly lower than those[(107.9±17.8)pg/ml,(10.1±2.5)mg/L,(42.2±5.8)μmol/L,(45.3±4.5)%and(5.2±0.6)mm/h]before treatment,and all the differences were statistically significant(t=21.644,12.902,40.393,9.468,25.194;p<0.001).In the control group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(60.6±17.8)pg/ml,(8.2±2.2)mg/L,(15.2±3.1)μmol/L,(40.2±3.4)%and(4.5±0.6)mm/h respectively,which were all significantly lower than those[(112.4±14.3)pg/ml,(9.3±3.8)mg/L,(41.1±2.8)μmol/L,(44.6±5.5)%and(5.4±0.8)mm/h]before treatment,and all the differences were statistically significant(t=20.292,2.241,55.456,3.320,8.050;p<0.05).After treatment,the above indicators in the study group were all significantly lower than those in the control group,and all the differences were statistically significant(t=2.962,8.595,5.508,3.064,17.178;p<0.05).3)In the study group,the levels of serum S-100βand HMGB-1 after treatment were(0.65±0.38)μg/L and(5.3±2.4)μg/L respectively,which were significantly lower than those[(0.91±0.32)μg/L and(8.1±2.0)μg/L]before treatment,and the differences were statistically significant(t=4.681,8.020;p<0.001).In the control group,the levels of serum S-100βand HMGB-1 after treatment were(0.78±0.27)μg/L and(6.4±2.2)μg/L respectively,which were significantly lower than those[(0.88±0.25)μg/L and(7.9±1.7)μg/L]before treatment,and the differences were statistically significant(t=2.431,p=.016;t=4.826,p<0.001).After treatment,the levels of serum S-100βand HMGB-1 in the study group were significantly lower than those in the control group,and the differences were statistically significant(t=2.495,p=.014;t=2.840,p=.005).4)There was no significant difference between two groups in the rate of adverse reactions,such as nausea,vomiting,poor appetite,dizziness,drowsiness,hepatic and renal injury during treatment(p>0.05).Conclusions:The efficacy of sodium valproate combined with levetiracetam is obviously better than that of sodium valproate alone in the treatment of children epilepsy.The children patients’serum S-100βand HMGB-1 are more significantly reduced,resulting in a lower rate of adverse reactions,which has a certain clinical value.展开更多
目的探讨缺氧缺血性脑病(HIE)新生儿血清生物标志物神经元特异性烯醇酶(NSE)、S-100B、Tau蛋白、激活素A等指标变化及诊断效能。方法选取2020年1月至2022年2月在温州医科大学附属台州医院出生或就诊的75例HIE足月新生儿为研究对象,按照...目的探讨缺氧缺血性脑病(HIE)新生儿血清生物标志物神经元特异性烯醇酶(NSE)、S-100B、Tau蛋白、激活素A等指标变化及诊断效能。方法选取2020年1月至2022年2月在温州医科大学附属台州医院出生或就诊的75例HIE足月新生儿为研究对象,按照HIE严重程度分为轻度HIE组30例,中度HIE组25例,重度HIE组20例。选取同期本院出生的75名健康足月新生儿为对照组。检测并比较4组研究对象血清生物标志物及神经发育指标[包括新生儿神经行为(NBNA)、发育商(DQ)],采用Pearson相关分析血清生物标志物与神经发育指标的相关性,ROC曲线分析各项血清生物标志物单独或联合检测对HIE的诊断效能。结果4组研究对象血清生物标志物及神经发育指标比较,差异均有统计学意义(均P<0.05),其中轻、中、重度HIE组患儿血清NSE、S-100B、Tau蛋白、激活素A水平均明显高于对照组(均P<0.05),且轻度HIE组<中度HIE组<重度HIE组(均P<0.05);生后7 d NBNA评分、生后35周DQ、生后52周DQ均明显低于对照组(均P<0.05),且轻度HIE组>中度HIE组>重度HIE组(均P<0.05)。血清NSE、S-100B、Tau蛋白、激活素A水平与生后7 d NBNA评分均呈负相关(r=-0.779、-0.788、-0.714、-0.800,均P<0.05);与生后35周DQ均呈负相关(r=-0.662、-0.700、-0.626、-0.674,均P<0.05),与生后52周DQ均呈负相关(r=-0.636、-0.684、-0.619、-0.632,均P<0.05)。血清NSE、S-100B、Tau蛋白、激活素A单独检测和4项联合检测诊断HIE的AUC分别为0.923、0.946、0.942、0.939和0.995,4项联合检测的诊断效能最佳。结论血清NSE、S-100B、Tau蛋白、激活素A与HIE新生儿神经发育有关,4项联合检测诊断HIE的效能较高。展开更多
文摘Objective:To explore the effects of sodium valproate combined with levetiracetam in the treatment of children epilepsy,and its influences on serum S-100βand high mobility group box-1(HMGB-1)in children with epilepsy.Methods:A total of 160 children who were diagnosed as epilepsy in Baogang Hospital of Inner Mongolia from July 2016 to October 2018 were selected as research objects.They were randomly divided into the study group(n=80)and the control group(n=80)by the random number table method,i.e.,they were treated with sodium valproate combined with levetiracetam and sodium valproate alone,respectively.After 16 weeks of treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge were evaluated,and chi-square test was used for statistical comparison.The related indicators,including serum tumor necrosis factor-(TNF-α),hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),haematocrit(HCT),erythrocyte sedimentation rate(ESR),serum S-100βand HMGB-1,were measured before and after treatment.Paired t-test was used for the comparison in the above indicators within a group before and after treatment;group t-test was used for the comparison between two groups.Chi-square test was used for the comparison in the rate of adverse reactions during treatment between two groups.The study was approved by Ethics Committee of Baogang Hospital(Approval No.:BG201606073),and all children’s guardians were required to sign informed consent forms for clinical study.There were no statistically significant differences between two groups in general clinical data(p>0.05),such as sex constituent ratio,age,the course of disease,the frequency of epileptic seizure per year before treatment,the incidence of epileptiform discharge before treatment and the constituent ratio of types of epileptic seizure,etc.Results:1)After treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge in the study group were 92.5%(74/80)and 85.0%(68/80)respectively,which were both significantly higher than those in the control group[68.8%(55/80)and 58.8%(47/80)],and the differences were statistically significant(Х^(2)=14.444,13.635;p<0.001).2)In the study group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(53.1±14.0)pg/ml,(5.0±2.5)mg/L,(12.5±3.1)μmol/L,(38.1±5.1)%and(3.0±0.5)mm/h respectively,which were all significantly lower than those[(107.9±17.8)pg/ml,(10.1±2.5)mg/L,(42.2±5.8)μmol/L,(45.3±4.5)%and(5.2±0.6)mm/h]before treatment,and all the differences were statistically significant(t=21.644,12.902,40.393,9.468,25.194;p<0.001).In the control group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(60.6±17.8)pg/ml,(8.2±2.2)mg/L,(15.2±3.1)μmol/L,(40.2±3.4)%and(4.5±0.6)mm/h respectively,which were all significantly lower than those[(112.4±14.3)pg/ml,(9.3±3.8)mg/L,(41.1±2.8)μmol/L,(44.6±5.5)%and(5.4±0.8)mm/h]before treatment,and all the differences were statistically significant(t=20.292,2.241,55.456,3.320,8.050;p<0.05).After treatment,the above indicators in the study group were all significantly lower than those in the control group,and all the differences were statistically significant(t=2.962,8.595,5.508,3.064,17.178;p<0.05).3)In the study group,the levels of serum S-100βand HMGB-1 after treatment were(0.65±0.38)μg/L and(5.3±2.4)μg/L respectively,which were significantly lower than those[(0.91±0.32)μg/L and(8.1±2.0)μg/L]before treatment,and the differences were statistically significant(t=4.681,8.020;p<0.001).In the control group,the levels of serum S-100βand HMGB-1 after treatment were(0.78±0.27)μg/L and(6.4±2.2)μg/L respectively,which were significantly lower than those[(0.88±0.25)μg/L and(7.9±1.7)μg/L]before treatment,and the differences were statistically significant(t=2.431,p=.016;t=4.826,p<0.001).After treatment,the levels of serum S-100βand HMGB-1 in the study group were significantly lower than those in the control group,and the differences were statistically significant(t=2.495,p=.014;t=2.840,p=.005).4)There was no significant difference between two groups in the rate of adverse reactions,such as nausea,vomiting,poor appetite,dizziness,drowsiness,hepatic and renal injury during treatment(p>0.05).Conclusions:The efficacy of sodium valproate combined with levetiracetam is obviously better than that of sodium valproate alone in the treatment of children epilepsy.The children patients’serum S-100βand HMGB-1 are more significantly reduced,resulting in a lower rate of adverse reactions,which has a certain clinical value.
文摘目的探讨缺氧缺血性脑病(HIE)新生儿血清生物标志物神经元特异性烯醇酶(NSE)、S-100B、Tau蛋白、激活素A等指标变化及诊断效能。方法选取2020年1月至2022年2月在温州医科大学附属台州医院出生或就诊的75例HIE足月新生儿为研究对象,按照HIE严重程度分为轻度HIE组30例,中度HIE组25例,重度HIE组20例。选取同期本院出生的75名健康足月新生儿为对照组。检测并比较4组研究对象血清生物标志物及神经发育指标[包括新生儿神经行为(NBNA)、发育商(DQ)],采用Pearson相关分析血清生物标志物与神经发育指标的相关性,ROC曲线分析各项血清生物标志物单独或联合检测对HIE的诊断效能。结果4组研究对象血清生物标志物及神经发育指标比较,差异均有统计学意义(均P<0.05),其中轻、中、重度HIE组患儿血清NSE、S-100B、Tau蛋白、激活素A水平均明显高于对照组(均P<0.05),且轻度HIE组<中度HIE组<重度HIE组(均P<0.05);生后7 d NBNA评分、生后35周DQ、生后52周DQ均明显低于对照组(均P<0.05),且轻度HIE组>中度HIE组>重度HIE组(均P<0.05)。血清NSE、S-100B、Tau蛋白、激活素A水平与生后7 d NBNA评分均呈负相关(r=-0.779、-0.788、-0.714、-0.800,均P<0.05);与生后35周DQ均呈负相关(r=-0.662、-0.700、-0.626、-0.674,均P<0.05),与生后52周DQ均呈负相关(r=-0.636、-0.684、-0.619、-0.632,均P<0.05)。血清NSE、S-100B、Tau蛋白、激活素A单独检测和4项联合检测诊断HIE的AUC分别为0.923、0.946、0.942、0.939和0.995,4项联合检测的诊断效能最佳。结论血清NSE、S-100B、Tau蛋白、激活素A与HIE新生儿神经发育有关,4项联合检测诊断HIE的效能较高。
