2019 年第 9 期 第 14 卷

吡拉西坦联合左乙拉西坦治疗小儿癫的效果及对认知功能的影响

Therapeutic effect of piracetam combined with levetiracetam on epilepsy in children and the effect on cognitive function

作者：周田蒲利华祝撷英

英文作者：

单位：710003西安市儿童医院神经内科

英文单位：

关键词：小儿癫；吡拉西坦；左乙拉西坦；认知功能

英文关键词：

• 摘要：

• 【摘要】目的    探究吡拉西坦联合左乙拉西坦对小儿癫的治疗效果及对患儿认知功能的影响。方法    选取2015年1月至2018年6月在西安市儿童医院进行治疗的癫患儿100例，依据随机数字表法分为对照组和观察组，各50例。对照组患儿服用左乙拉西坦片治疗；观察组患儿在对照组基础上加服吡拉西坦片治疗。检测2组血清高迁移率族蛋白1（HMGB1）、胰岛素样生长因子1（IGF-1）、白细胞介素6（IL-6）、免疫球蛋白（Ig）A和IgG表达水平，运用韦氏儿童智力量表（WISC-CR）对患儿认知功能进行评价，观察分析2组治疗效果及治疗过程中并发症发生情况。结果    治疗后2组血清HMGB1、IGF-1、IL-6、IgA、IgG水平均明显低于治疗前，且观察组明显低于对照组［（4.2±0.6）μg/L比（5.1±0.7）μg/L、（66±8）μg/L比（74±9）μg/L、（6.6±0.6）ng/L比（7.1±0.7）ng/L、（0.52±0.11）g/L比（1.23±0.23）g/L、（6.1±0.4）g/L比（6.6±0.6）g/L］（均P＜0.05）。治疗后2组WISC-CR评分均明显高于治疗前，且观察组明显高于对照组［（87±10）分比（80±10）分］（均P＜0.05）。观察组的总有效率明显高于对照组［96.0%（48/50）比82.0%（41/50）］（P＝0.03）。观察组的并发症发生率明显低于对照组［6.0%（3/50）比20.0%（10/50）］（P＝0.04）。结论    吡拉西坦联合左乙拉西坦治疗可以有效调节癫患儿炎性因子的表达水平，改善患儿的认知功能，减少并发症的发生。

• 【Abstract】Objective    To explore the therapeutic effect of piracetam combined with levetiracetam on children with epilepsy and the effect on cognitive function. Methods    Totally 100 children with epilepsy admitted to Xi′an Children′s Hospital from January 2015 to June 2018 were randomly divided into observation group and control group, with 50 cases in each group. The control group was treated with levetiracetam and the observation group was treated with levetiracetam plus piracetam. Serum levels of high mobility group protein 1(HMGB1), insulin-like growth factor-1(IGF-1), interleukin-6(IL-6), immunoglobulin(Ig) A and IgG were detected. Cognitive function was assessed by Wechsler Intelligence Scale for Children-Chinese Revision(WISC-CR). Therapeutic effect and complications during treatment were observed. Results    After treatment, levels of serum HMGB1, IGF-1, IL-6, IgA and IgG significantly decreased and the levels in observation group were significantly lower than those in control group［（4.2±0.6）μg/L vs （5.1±0.7）μg/L, （66±8）μg/L vs （74±9）μg/L, （6.6±0.6）ng/L vs （7.1±0.7）ng/L, （0.52±0.11）g/L vs （1.23±0.23）g/L, （6.1±0.4）g/L vs （6.6±0.6）g/L］（all P＜0.05）. WISC-CR score significantly increased after treatment and the score in observation group was significantly higher than that in control group［（87±10） vs （80±10）］（P＜0.05）. Total effective rate in observation group was significantly higher than that in control group［96.0%（48/50） vs 82.0%（41/50）］（P＝0.03）. Incidence of complications in observation group was significantly lower than that in control group［6.0%（3/50） vs 20.0%（10/50）］（P＝0.04）. Conclusion    Piracetam combined with levetiracetam treating epilepsy in children can effectively regulate the expression of inflammatory factors, improve cognitive function and reduce complications.