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目的探讨癫痫儿童认知功能、卡马西平(CBZ)和丙戊酸钠(VPA)血药浓度受吡拉西坦(Pir)的影响。方法 52例癫痫患儿,根据患儿的情况分为全面性发作组(24例)和部分性发作组(28例),分别接受VPA、CBZ治疗;另选同期23例健康儿童作为对照组。观察比较三组的平均智商和治疗3个月后、加用Pir 9个月后事件相关电位P300潜伏期(ERP P300PL),以及VPA、CBZ血药浓度。结果对照组平均智商为(98.3±10.8),全面性发作组平均智商为(74.5±11.3),部分性发作组平均智商为(81.5±12.0,对照组智商明显高于全面性发作组和部分性发作组,差异具有统计学意义(P<0.01);治疗3个月后,全面性发作组和部分性发作组的P300PL逐渐缩短,全面性发作组的平均缩短值为(379.6±39.1)ms,部分性发作组平均缩短值为(357.4±27.3)ms,两组比较差异具有统计学意义(P<0.01);加用Pir 9个月后,全面性发作组的P300PL缩短为(333.8±29.5)ms,部分性发作组的P300PL缩短为(341.7±28.3)ms,两组比较差异具有统计学意义(P<0.01)。全面性发作组和部分性发作组组加Pir前与加用Pir 9个月后的CBZ、VPA血药浓度组内比较差异无统计学意义(P>0.05)。结论 Pir不会影响CBZ和VPA的血药浓度,对患儿的认知损害有所缓解,能够提升癫痫儿童反应能力。
Objective To investigate the cognitive function of children with epilepsy, carbamazepine (CBZ) and sodium valproate (VPA) plasma concentrations of piracetam (Pir) influence. Methods Fifty-two children with epilepsy were divided into comprehensive attack group (n = 24) and partial paroxysm group (n = 28) according to the condition of their children, and received VPA and CBZ respectively. Another 23 healthy children were selected as the control group. The mean IQ of the three groups was observed and compared. After 3 months of treatment, P300 latency (ERP P300PL) and plasma concentrations of VPA and CBZ after 9 months of Pir administration were also compared. Results The average IQ of the control group was (98.3 ± 10.8), that of the generalized attack group was (74.5 ± 11.3), that of the partial seizure group was (81.5 ± 12.0), that of the control group was significantly higher than that of the generalized seizure group and the partial (P <0.01). After 3 months of treatment, the P300PL of the generalized and partial seizure groups gradually shortened, and the mean shortening of the generalized seizure group was (379.6 ± 39.1) ms, with a significant difference The average shortening of the partial seizure group was (357.4 ± 27.3) ms, the difference between the two groups was statistically significant (P <0.01); P300PL of the comprehensive seizure group was (333.8 ± 29.5) (P <0.01), and P300PL in partial seizures was (341.7 ± 28.3) ms, with significant difference between the two groups (P <0.01) .In the comprehensive seizure group and the partial seizure group, 9 There was no significant difference in plasma concentrations of CBZ and VPA between the two groups (P> 0.05) .Conclusion Pir does not affect the blood concentration of CBZ and VPA, relieve the cognitive impairment in children and elevate epilepsy Children’s ability to respond.