丙戊酸钠联合奥卡西平治疗小儿癫痫的疗效及对患儿脑电图、认知功能和血清神经因子的影响

摘要 目的：评价丙戊酸钠联合奥卡西平治疗小儿癫痫的疗效及对患儿脑电图、认知功能和血清神经因子的影响。方法：选入2019年1月~2022年12月收治的癫痫患儿104例，根据治疗方法不同分为单药组（丙戊酸钠治疗）和联合组（丙戊酸钠+奥卡西平治疗），各52例。评价两组的临床疗效、脑电图、认知功能、血清神经因子等指标，并进行统计比较。结果：联合组治疗后癫痫发作频率及每次持续时间显著低于单药组（P<0.05），EEG显示痫样放电率、总异常亦明显低于单药组（P＜0.05）；联合组治疗总有效率94.23%，明显高于单药组的71.15%（P<0.05）；两组治疗后WISC-CR量表VIQ、PIQ和FIQ评分均较治疗前明显升高（P<0.05），而联合组升高幅度更大，与单药组差异显著（P<0.05）；治疗前，两组血清BDNF、NSE和S-100β蛋白无明显差异（P＞0.05），而治疗后，联合组血清BDNF水平明显高于单药组、NSE和S-100β水平显著低于单药组（P＜0.05）；两组不良反应总发生率无差异（P＞0.05）。结论：丙戊酸钠联合奥卡西平治疗小儿癫痫疗效较好，可有效缓解临床症状，控制脑部异常放电，改善认知功能，调节血清神经因子水平，且安全性良好。

The Efficacy of Sodium Valproate Combined with Oxcarbazepine in the Treatment of Pediatric Epilepsy and Its Effects on Electroencephalogram, Cognitive Function, and Serum Neurotrophic Factors

ABSTRACT Objective: To evaluate the efficacy of sodium valproate combined with oxcarbazepine in the treatment of pediatric epilepsy and its effects on electroencephalogram, cognitive function and serum neurotrophic factors. Methods: 104 children with epilepsy from January 2019 to December 2022 were selected and divided into a monotherapy group (sodium valproate treatment) and a combination group (sodium valproate + oxcarbazepine treatment) based on different treatment methods, with 52 cases in each group. Evaluate and compare the clinical efficacy, EEG, cognitive function, serum neurofactors, and other indicators between the two groups. Results: After treatment, the frequency and duration of seizures in the combination group were lower than those in the monotherapy group (P<0.05), and the EEG showed a lower epileptiform discharge rate and total abnormality compared to the monotherapy group (P<0.05). The total effective rate of the combination group was 94.23%, higher than 71.15% in the monotherapy group (P<0.05). After treatment, the scores of VIQ, PIQ, and FIQ on the WISC-CR scale in both groups were higher than before treatment (P<0.05), while the increase in the combination group was greater than that in the monotherapy group (P<0.05). There was no difference in serum BDNF, NSE and S-100β between the two groups before treatment (P>0.05), but after treatment, the serum BDNF level in the combination group were higher than that in the monotherapy group, NSE and S-100β levels were lower than those in the monotherapy group (P<0.05). There was no difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Valproate combined with oxcarbamazepine is effective in pediatric epilepsy, which can effectively relieve clinical symptoms, control abnormal brain discharge, improve cognitive function, regulate the level of serum nerve factors, and have good safety.