【摘要】 目的:探讨丙戊酸钠联合托吡酯在大剂量冲击模式下对儿童癫痫的效果及血清IGF-1、GFAP水平的影响。方法:选取2018年10月-2020年4月本院收治的127例癫痫患儿为研究对象。按照给药方案分为试验组62例与对照组65例。试验组口服丙戊酸钠25 mg/(kg·d),同时联合服用托吡酯,起始给药剂量为10 mg/(kg·d),分2次服用,连续服用3 d,之后逐渐降低并维持剂量7～8 mg/(kg·d);对照组丙戊酸钠同试验组,托吡酯起始剂量为1 mg/(kg·d),剂量逐渐增加至6 mg/(kg·d)。两组治疗时间均为3个月。比较两组患癫痫发作减少率、疗效、放电指数、不良反应及血清IGF-1、GFAP水平差异。结果:试验组总有效率91.94%,高于对照组的72.31%(P<0.05)。试验组癫痫发作频率减少率高于对照组(P<0.05)。两组治疗后放电指数比较,差异有统计学意义(P<0.05)。试验组治疗后血清IGF-1、GFAP水平均低于对照组(P<0.05)。试验组不良反应发生率为17.74%,虽低于对照组的20.00%,但两组比较差异无统计学意义(P>0.05)。结论:丙戊酸钠联合托吡酯在大剂量冲击模式下对儿童癫痫有较好的治疗效果,有效降低癫痫发作频率和脑放电异常,保护神经系统功能,减少脑损伤,具有显著临床应用价值。更多还原

【Abstract】 Objective:To study the effect of Sodium Valproate combined with Topiramate under high-dose shock mode for epilepsy in children and its influence on the levels of serum IGF-1 and GFAP.Method:A total of 127 children with epilepsy admitted to our hospital from October 2018 to April 2020 were selected as the research objects.According to the administration scheme,they were divided into the experimental group (n=62) and the control group (n=65).The experimental group was given Sodium Valproate 25 mg/(kg·d) orally,combined with Topiramate,with an initial dose of 10 mg/(kg·d),divided into two times for 3 consecutive days,then gradually reduced and maintained the dose of 7-8 mg/(kg·d);Sodium Valproate in the control group was the same as that in the experimental group,the initial dose of Topiramate in the control group was 1 mg/(kg·d) and the dose gradually increased to 6 mg/(kg·d).The treatment time of two groups was 3 months.The epileptic seizure reduction rate,curative effect,discharge index,adverse reactions,serum IGF-1 and GFAP levels were compared between two groups.Result:The total effective rate in the experimental group was 91.94%,higher than 72.31% in the control group (P<0.05).The decrease rate of seizure frequency in the experimental group was higher than that in the control group (P<0.05).There were significant differences in discharge index between two groups after treatment (P<0.05).The levels of serum IGF-1 and GFAP in the experimental group after treatment were lower than those in the control group (P<0.05).The incidence of adverse reactions in the experimental group was 17.74%,which was lower than 20.00% in the control group,but there was no significant difference between two groups (P>0.05).Conclusion:Sodium Valproate combined with Topiramate has a good therapeutic effect on childhood epilepsy under high-dose shock mode,can effectively reduce the frequency of epileptic seizures and abnormal brain discharge,protecte the function of nervous system,and reduce brain damage,it has significant clinical application value.更多还原