甲泼尼龙冲击联合左乙拉西坦治疗儿童睡眠期癫痫性电持续状态的临床研究

工作单位:1.361003 福建 厦门,厦门大学附属妇女医院,厦门市妇幼保健院儿童神经康复科;2.厦门市湖里区妇幼保健院儿童保健科

 睡眠期癫痫性电持续状态;儿童;左乙拉西坦;甲泼尼龙冲击疗法

Clinical Study of Methylprednisolone Combined with Levetiracetam in the Treatment of Children Electrical Status Epilepticus during Sleep
CAI Huiqiang1, ZHANG Duanxiu2

(1.Department of Children Neurological Rehabilitation, Xiamen Maternal and Child Health Hospital, Xiamen 361000, Fujian Province, China; 2. Department of Children's Health, Huli District of Xiamen Maternal and Child Health Hospital)

 Electrical Status Epilepticus during Sleep; Child; Levetiracetam; Methylprednisolone Impact Therapy

DOI: 10.3969/j.issn.1672-7185.2020.06.009

备注

 目的  探讨甲泼尼龙冲击结合左乙拉西坦治疗儿童睡眠期癫痫性电持续状态( ESE S)的作用价值。方法  选取厦门市妇幼保健院2013年2月—2019年3月收治的E S ES患儿86例为研究对象,随机分为对照组与观察组各43例,对照组予以口服左乙拉西坦治疗,观察组予以甲泼尼龙冲击联合左乙拉西坦治疗,比较两组患儿治疗6个月后智力测试评分、临床疗效、脑电图变化疗效及不良反应发生情况。结果  治疗6个月后,观察组临床治疗总有效率、脑电图变化总有效率均高于对照组,差异有统计学意义(P<0.05);两组语言智商(VIQ)评分、操作智商(PIQ)评分、全量表智商(FIQ)评分均高于治疗前,且观察组高于对照组,差异有统计学意义 (P<0.05);观察组不良反应发生率高于对照组,差异无统计学意义(P>0.05),两组不良反应症状均较轻,停药后均消失。结论  甲泼尼龙冲击联合左乙拉西坦治疗儿童E S ES,可有效改善临床症状及脑电图表现,提升患儿智力水平,虽然不良反应稍有增加,但停药后消失,安全性较高。
 Objective  To explore the value of methylprednisolone combined with levetiracetam in the treatment of children with epilepsy electrical status(ESES) during sleep. Methods  86 cases of ESES children treated in our hospital from February 2013 to March 2019 were selected as the research objects, and the random number table method was used to divide them into a reference group (n=43 cases) and an observation group(n=43 cases). The control group was treated with levetiracetam, the observation group with methylprednisolone and levetiracetam. The reference group was given oral levetiracetam, and the observation group was given methylprednisolone combined with levetiracetam. Observe and compare the intelligence test scores, clinical efficacy, EEG changes, and adverse reactions after 6 months of treatment in the two groups. Results  After 6 months of treatment, the total effective rate of clinical treatment in the observation group (90.70%) was higher than that in the reference group (74.42%) (P<0.05); The total effective rate of EEG changes in the observation group (83.72%) was higher than that in the reference group (55.81%) (P<0.05); After 6 months of treatment, the IQ score, PIQ score and FIQ score of the two groups were higher than before treatment, and the observation group was significantly higher than the reference group (P<0.05); The incidence of adverse reactions in the observation group (13.95%) was slightly higher than that in the reference group (6.98%), but the difference was not statistically significant (P>0.05); The symptoms of adverse reactions were mild in both groups and disappeared after stopping the drug. Conclusion  Methylprednisolone combined with levetiracetam in the treatment of ESES in children can effectively improve clinical symptoms and EEG performance, and improve the child’s intelligence level. Although the adverse reactions slightly increased, it disappeared after stopping the drug and the safety was higher.