丙戊酸、奥卡西平、左乙拉西坦单药治疗对学龄期癫痫患儿的疗效及骨代谢水平影响

目的研究探讨单药应用丙戊酸、奥卡西平和左乙拉西坦三种抗癫痫药物对学龄期癫痫患儿临床疗效和骨代谢水平的影响。方法选取2015年6月-2018年6月保定市儿童医院收治的学龄期癫痫患儿150例,采用随机数表法分为3组,每组各50例,A组给予奥卡西平,B组给予左乙拉西坦,C组给予丙戊酸,均进行单药治疗,治疗6个月后,评价并比较三组疗效及治疗前后骨代谢指标水平变化情况。结果治疗后与治疗前比较,A组血清Ca与25-(OH)D水平下降、ALP水平升高、差异有统计学意义(t=21.125、4.037、4.976,P<0.001);B组仅ALP水平显著升高(t=2.321,P<0.05);C组血清Ca、25-(OH)D与BMD水平显著下降、ALP与BAP水平显著升高(t=31.596、5.991、3.591、3.239、4.643,P<0.001)。三组间治疗总有效率比较差异有统计学意义(P<0.05)。结论对于癫痫患儿,左乙拉西坦在疗效上优于丙戊酸,在不良反应上优于奥卡西平,且对学龄期患儿的骨代谢指标影响也为最小,安全有效,值得应用。

Effects of valproic acid,oxcarbazepine and levetiracetam monotherapy on the efficacy and bone metabolism of school-age children with epilepsy

Objective To investigate the efficacy of three antiepileptic drugs on epilepsy,including valproic acid,oxcarbazepine and levetiracetam,and to analyze their effects on bone metabolism of children with school-age children. Methods A total of 150 school-age children with epilepsy admitted to Baoding Children′s Hospital were enrolled in this study from June 2015 to June 2018,and were randomly divided into three groups,with 50 cases in each group.Group A received oxcarbazepine,group B received levetiracetam,while group C was given valproic acid for monotherapy.After 6 months of treatment,the efficacy of three drugs was evaluated.The changes in bone metabolic markers before and after intervention were compared. Results After treatment,the levels of Ca and 25- (OH) D in group A significantly decreased,while ALP level significantly increased (t=21.125,4.037,4.976,P＜0.001).ALP level in group B was significantly higher after treatment (t=2.321,P＜0.05).Moreover,the levels of Ca,25- (OH)D and BMD in group C significantly decreased after treatment,while the levels of ALP and BAP significantly increased after treatment (t=31.596,5.991,3.591,3.239,4.643,P＜0.001).The total effective rates of three groups were significantly different (P＜0.05). Conclusions For children with epilepsy,the efficacy of levetiracetam is superior to that of valproic acid,and the adverse reaction of levetiracetam is less than oxcarbazepine.It is worth noting that levetiracetam has the least impact on bone metabolism indicators in school-age children.Because of its safety and effectiveness,levetiracetam is worth of clinical application.