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目的探讨传统抗癫痫药物(AEDs)对癫痫患儿血清神经元特异性烯醇化酶(NSE)的影响。方法 2008年6月至2009年12月乌鲁木齐儿童医院神经内科门诊或住院新确诊癫痫患儿111例(>2岁66例、≤2岁45例),分为2组,丙戊酸(VPA)组给予VPA15～40mg(/kg·d),分1～2次口服治疗;卡马西平(CBZ)组初始量10mg(/kg·d),最大剂量≤30mg(/kg·d),分2次口服,总剂量≤1000mg/d。正常对照组为同期本院儿保科体检儿童68名。各组癫痫患儿在治疗前(末次发作后2d)、治疗3个月和6个月3次取静脉血。酶联免疫法测定血清NSE含量。结果 (1)>2岁:VPA组、CBZ组治疗前NSE均比正常对照组高(P<0.01);VPA组、CBZ组治疗3个月后NSE较治疗前明显下降(P<0.01);两组同时点3次NSE比较差异无统计学意义。(2)≤2岁:VPA组、CBZ组治疗前NSE比正常对照组高(P<0.01);VPA组治疗3个月及6个月后与正常对照组比较,NSE差异无统计学意义;CBZ组治疗3个月后NSE与正常对照比较差异无统计学意义,继续治疗至6个月后NSE明显高于正常对照组(P<0.05)。结论各年龄癫痫患儿治疗前的血清NSE水平明显增高,提示可能与癫痫发作有关。常规剂量VPA对各年龄癫痫患儿血清NSE无明显影响;长程服用常规剂量CBZ对≤2岁癫痫患儿血清NSE有一定影响,其最终结论有待更多临床及动物实验观察。
Objective To investigate the effect of traditional antiepileptic drugs (AEDs) on serum neuron specific enolase (NSE) in children with epilepsy. Methods From June 2008 to December 2009, 111 children newly diagnosed epilepsy in Urumchi Children’s Hospital (66 patients aged> 2 years, 45 patients ≤2 years old) were divided into two groups: VPA group, Group was given VPA15 ~ 40mg (/ kg · d), 1 or 2 times oral treatment; carbamazepine (CBZ) group initial dose of 10mg (/ kg · d), the maximum dose of ≤ 30mg (/ kg · d) Oral administration, the total dose ≤ 1000mg / d. The normal control group for the same period in our hospital child protection subjects 68 children. Children with epilepsy in each group before treatment (2d after the last episode), 3 months and 6 months 3 times to take venous blood. Determination of serum NSE by enzyme-linked immunosorbent assay. Results The NSE in VPA group and CBZ group before treatment were significantly higher than those in normal control group (P <0.01). The NSE in VPA group and CBZ group was significantly decreased 3 months after treatment (P <0.01). There was no significant difference between the two groups in 3 times of NSE at the same time. (2) ≤2 years old: The NSE in VPA group and CBZ group before treatment were higher than those in normal control group (P <0.01). There was no significant difference in NSE between VPA group and normal control group at 3 and 6 months after treatment There was no significant difference between the NSE and the normal control group in the CBZ group 3 months after treatment. NSE was significantly higher in the CBZ group than in the normal control group (P <0.05) after 6 months of treatment. Conclusion Serum levels of NSE in children with epilepsy at various ages were significantly higher than those before treatment, suggesting that they may be related to seizures. The routine dose of VPA had no significant effect on the serum NSE of children with epilepsy at all ages. The long-term use of conventional dose of CBZ had some effect on serum NSE in children with ≤2 years of epilepsy. The final conclusion needs more clinical and animal experiments.