摘要
目的 探讨奥卡西平联合左乙拉西坦治疗小儿癫痫的临床效果以及对患儿认知功能的影响。方法 60例癫痫患儿,通过随机数字表法进行分组,即观察组及对照组,均30例。对照组予以奥卡西平单独治疗,观察组联合奥卡西平与左乙拉西坦治疗。比较两组患儿的治疗效果、免疫功能指标[免疫球蛋白(Ig)A、Ig M、Ig G、CD3^(+)、CD4^(+)]水平、认知功能指标[总智商(FIQ)、操作智商(PIQ)、言语智商(VIQ)]水平、不良反应发生情况,症状改善指标(临床症状好转时间、癫痫持续时间、癫痫发作次数)。结果 (1)和对照组进行比较,观察组治疗总有效率显著较高,其中对照组治疗总有效率为73.33%,观察组为93.33%(χ^(2)=4.320,P=0.038<0.05)。(2)治疗后,两组患儿的Ig A、Ig M、Ig G、CD3^(+)、CD4^(+)水平均升高,且观察组患儿的Ig A、Ig M、Ig G、CD3^(+)、CD4^(+)水平分别为(1.26±0.12)g/L、(1.34±0.29)g/L、(14.48±1.22)g/L、(72.02±9.36)%、(50.30±7.12)%,高于对照组的(1.08±0.16)g/L、(1.03±0.30)g/L、(12.32±1.60)g/L、(64.26±9.08)%、(45.23±7.52)%,差异显著(P<0.05)。(3)治疗后,两组患儿的FIQ、PIQ、VIQ水平均升高,且观察组患儿的FIQ、PIQ、VIQ水平分别为(99.26±1.04)、(98.25±1.18)、(98.39±1.94)分,均高于对照组的(98.05±1.13)、(96.29±1.29)、(96.32±1.78)分,差异显著(P<0.05)。(4)对照组和观察组患儿的不良反应发生率比较,无统计学差异(P>0.05)。(5)观察组患儿的临床症状好转时间(6.59±1.75)d、癫痫持续时间(1.33±0.13)min/次短于对照组的(10.71±1.99)d、(4.26±1.66)min/次,癫痫发作次数(1.33±0.22)次/d少于对照组的(2.75±1.69)次/d,差异显著(P<0.05)。结论 癫痫患儿联合应用奥卡西平与左乙拉西坦治疗能够发挥显著效果,不仅能够改善患儿的免疫功能,而且可改善患儿的认知功能,利于患儿病情康复,值得推广应用。
Objective To discuss the clinical effect of combined therapy with oxcarbazepine and levetiracetam in the treatment of pediatric epilepsy and its influence on cognitive function of children.Methods60 children with epilepsy were divided into an observation group and a control group by random number table method,with 30 cases in each group.The control group was treated with oxcarbazepine alone,and the observation group was treated with oxcarbazepine and levetiracetam.Both groups were compared in terms of therapeutic effects,immune function indicators[immunoglobulin (Ig) A,Ig M,Ig G,CD3^(+),CD4^(+)]levels,cognitive function indicators[full intelligence quotient (FIQ),performance intelligence quotient (PIQ),verbal intelligence quotient(VIQ)]levels,the occurrence of adverse reactions,symptom improvement indicators (time to improvement of clinical symptom,duration of epilepsy,number of seizures).Results (i) Compared with the control group,the total effective rate of the observation group was significantly higher,with 73.33%in the control group and 93.33%in the observation group (χ^(2)=4.320,P=0.038<0.05).(ii) After treatment,the levels of Ig A,Ig M,Ig G,CD3^(+),and CD4^(+)in both groups of children increased,and the levels of Ig A,Ig M,Ig G,CD3^(+),and CD4^(+)in the observation group were (1.26±0.12) g/L,(1.34±0.29) g/L,(14.48±1.22) g/L,(72.02±9.36)%,and (50.30±7.12)%,which were higher than those of (1.08±0.16) g/L,(1.03±0.30) g/L,(12.32±1.60) g/L,(64.26±9.08)%,and(45.23±7.52)%in the control group.The difference was significant (P<0.05).(iii) After treatment,FIQ,PIQ and VIQ levels of children in both groups were increased,and FIQ,PIQ and VIQ levels of children in the observation group were (99.26±1.04),(98.25±1.18) and (98.39±1.94) points,which were higher than those of (98.05±1.13),(96.29±1.29) and (96.32±1.78) points in the control group.The difference was significant (P<0.05).(iv) There was no significant difference in the incidence of adverse reactions between the control group and the observation group (P>0.05).(v) The time to improvement of clinical symptoms in the observation group was (6.59±1.75) d,the duration of epilepsy was (1.33±0.13) min/time,which were shorter than those of (10.71±1.99) d and (4.26±1.66) min/time in the control group,and the number of seizures (1.33±0.22) times/d was less than that of(2.75±1.69) times/d in the control group.The difference was significant (P<0.05).Conclusion The combined use of oxcarbazepine and levetiracetam in the treatment of children with epilepsy can play a prominent role.It can not only improve the immune function of children,but also improve the cognitive function of patients,which is beneficial to the rehabilitation of children,and is worth promoting and applying.
作者
李彩云
徐成
许青国
黄瑞
LI Cai-yun;XU Cheng;XU Qing-guo(Department of Pediatrics,Dongchangfu People's Hospital,Liaocheng 252000,China)
出处
《中国实用医药》
2024年第2期19-23,共5页
China Practical Medicine
关键词
小儿癫痫
奥卡西平
左乙拉西坦
治疗效果
认知功能
免疫功能
Pediatric epilepsy
Oxcarbazepine
Levetiracetam
Therapeutic effect
Cognitive function
Immune function
作者简介
通讯作者:黄瑞。
