摘要
目的:比较左乙拉西坦与丙戊酸钠治疗儿童枕叶癫痫(COE)睡眠中癫痫性电持续状态(ESES)的临床疗效及对认知功能的影响,为临床提供参考。方法:将42例COE-ESES按就诊序号奇偶数分为左乙拉西坦组和丙戊酸钠组各21例,分别给予相应药物治疗,用韦氏儿童智力量表检查两组患儿治疗前后的语言智商(VIQ)、操作智商(PIQ)、全量表智商(FIQ),观察临床发作及长程视频脑电图的变化情况。结果:左乙拉西坦组对临床发作的总有效率为76.2%,与丙戊酸钠组的61.9%比较,差异无统计学意义(P>0.05);对脑电图改善的总有效率为66.7%,高于丙戊酸钠组的42.9%(P<0.05)。治疗前,左乙拉西坦组PIQ(101.5±2.5)分、VIQ(91.5±2.5)分、FIQ(91.3±2.0)分,丙戊酸钠组PIQ(101.7±2.5)分、VIQ(91.5±2.7)分、FIQ(91.6±2.0)分,两组比较差异均无统计学意义(P均>0.05);治疗后,左乙拉西坦组PIQ(102.1±3.2)分、VIQ(99.9±5.9)分、FIQ(99.9±5.8)分,丙戊酸钠组PIQ(101.8±3.3)分、VIQ(93.4±4.2)分、FIQ(93.1±3.7)分,两组FIQ、VIQ评分比较差异均有统计学意义(P均<0.05),而PIQ评分比较差异无统计学意义(P>0.05)。左乙拉西坦组发生药物不良反应1例(4.8%),丙戊酸钠组2例(9.5%)。结论:左乙拉西坦对儿童COE-ESES安全有效,且在改善认知功能、缓解脑电图电持续状态方面优于丙戊酸钠。
Objective:To compare the efficacy of levetiracetam and sodium valproate in the treatment of childhood occipital epilepsy(COE)electrical status epilepticus during sleep(ESES)and its effects on cognitive function,so as to provide reference for clinical practice.Methods:Totally 42 patients with COE-ESES were extracted to be divided into the levetiracetam group and the sodium valproate group via the admission sequence,with 21 cases in each group.Corresponding drug treatment was performed.Verbal intelligence quotient(VIQ),operational intelligence quotient(PIQ)and full-scale intelligence quotient(FIQ)of two groups were examined by Wechsler intelligence scale for children before and after treatment.Changes in clinical attack and long-term video electroencephalogram were observed.Results:The total effective rate of the levetiracetam group for clinical onset was 76.2%,compared with 61.9%of the sodium valproate group,the difference was not statistically significant(P>0.05).The total effective rate of EEG improvement in the levetiracetam group was 66.7%,higher than 42.9%in the sodium valproate group(P<0.05).Before treatment,PIQ,VIQ and FIQ of the levetiracetam group were respectively(101.5±2.5)points,(91.5±2.5)points and(91.3±2.0)points,while those of the sodium valproate group were respectively(101.7±2.5)points,(91.5±2.7)points and(91.6±2.0)points,without any statistically significant difference(P>0.05).After treatment,PIQ,VIQ and FIQ of the levetiracetam group were respectively(102.1±3.2)points,(99.9±5.9)points and(99.9±5.8)points,while those of the sodium valproate group were respectively(101.8±3.3)points,(93.4±4.2)points and(93.1±3.7)points,the differences in FIQ and VIQ between two groups were statistically significant(P<0.05),the differences in PIQ were not statistically significant(P>0.05).There was one case(4.8%)of adverse drug reaction in the levetiracetam group and two cases(9.5%)in the sodium valproate group.Conclusion:Levetiracetam was safe and effective in the treatment of children with COE-ESES,and levetiracetam is better than sodium valproate in improving cognitive function and relieving the electroencephalogram continuous electrical status epilepticus.
作者
李立佳
邹琴
阎青青
王丹
冯业成
Li Lijia;Zou Qin;Yan Qingqing;Wang Dan;Feng Yecheng(The First Affiliated Hospital of Hainan Medical College,Hainan Haikou 570102,China)
出处
《儿科药学杂志》
CAS
2021年第6期1-4,共4页
Journal of Pediatric Pharmacy
基金
海南省卫生计生行业科研项目,编号18A200082。
关键词
左乙拉西坦
儿童
枕叶癫痫
睡眠中癫痫电持续状态
认知功能
levetiracetam
children
occipital epilepsy
electrical status epilepticus during sleep
cognitive function
