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目的观察应用胡椒碱衍生物伊来西胺添加治疗癫痫患儿血清特异性烯醇化酶(neuron specific enolase,NSE)水平变化。方法 107例癫痫患儿采用随机数字表法分为试验组(77例)及对照组(30例),对照组只采用抗癫痫西药治疗,试验在组抗癫痫西药的基础上加用伊莱西胺,初始剂量均为每日5mg/kg,分2次服用,发作未被控制的患儿给予逐渐加量,每周加量<每日10mg/kg。观察疗程为1年。治疗前、治疗0.5年以及治疗1年时行脑电图(EEG)检测,并采用电化学发光法检测血清NSE水平,治疗1年时进行癫痫疗效评估。结果治疗后试验组总有效率[65.0%(50/77)]高于对照组[30.0%(9/30)],差异有统计学意义(P<0.01)。与本组治疗前比较,试验组治疗0.5年及1年NES水平明显下降,且治疗1年NES水平低于治疗0.5年(P<0.05,P<0.01)。对照组各时间点及与试验之间比较,差异无统计学意义(P>0.05)。试验组治疗1年时EEG(3例正常范围EEG,5例界线性EEG,69例异常EEG)明显优于治疗前EEG(2例正常范围EEG,75例异常EEG)水平,差异有统计学意义(Z=-2.33,P<0.05);对照组30例患儿治疗前EEG(均为异常EEG)与治疗1年EEG(3例界线性EEG,27例异常EEG)比较,差异无统计学意义(Z=-1.732,P>0.05)。结论癫痫患儿添加胡椒碱衍生物治疗可以降低血清NSE水平,减少癫痫发作频度,脑电图得到改善。
Objective To observe the change of serum level of neuron specific enolase (NSE) in children with epilepsy by using the piperine derivative ililanxide. Methods A total of 107 children with epilepsy were divided into experimental group (n = 77) and control group (n = 30) by random number table. The control group was treated with antiepileptic western medicine. Based on the group of antiepileptic western medicine, Amine, the initial dose of 5mg / kg daily, taking 2 times, the onset of uncontrolled children given a gradual increase in the amount of weekly dosage <10mg / kg daily. Observation of treatment for 1 year. Before treatment, 0.5 years of treatment and 1 year of treatment were measured by electroencephalography (EEG), and the level of serum NSE was detected by electrochemiluminescence. The efficacy of epilepsy was evaluated after 1 year of treatment. Results After treatment, the total effective rate (65.0% (50/77)] in the experimental group was significantly higher than that in the control group (30.0%, 9/30). The difference was statistically significant (P <0.01). Compared with the pretreatment group, the NES level in the experimental group decreased significantly at 0. 5 years and 1 year, and the NES level at 1 year of treatment was lower than that of the treated 0.5 year (P <0.05, P <0.01). The control group at each time point and compared with the test, the difference was not statistically significant (P> 0.05). EEG (3 cases of normal range EEG, 5 cases of borderline EEG and 69 cases of abnormal EEG) was significantly better than EEG (2 cases of normal range EEG, 75 cases of abnormal EEG) in experimental group at 1 year of treatment, the difference was statistically significant (Z = -2.33, P <0.05). There was no significant difference in the EEG (both abnormal EEG) and the one-year EEG (3 borderline EEG, 27 abnormal EEG) between the control group and the 30 patients (Z = -1.732, P> 0.05). Conclusion The addition of piperine derivatives to children with epilepsy can reduce serum NSE levels, reduce the frequency of seizures and improve the EEG.