丙戊酸钠、奥卡西平与左乙拉西坦分别治疗小儿癫痫的疗效及对认知功能的影响

目的 探讨丙戊酸钠、奥卡西平与左乙拉西坦分别治疗小儿癫痫的疗效及对小儿认知功能的影响。方法 收取2011年4月—2016年1月于渭南市妇幼保健院进行治疗的癫痫患儿96例作为研究对象，根据随机数字表法将其分为A、B、C组，每组各32例，分别使用丙戊酸钠、奥卡西平或左乙拉西坦进行治疗，3组患儿均治疗16周。对3组患儿临床疗效、脑电变化情况、认知功能变化情况以及用药安全性进行观察与比较。结果 A、B、C组治疗总有效率分别为71.88%、78.13%、90.63%，C组高于A、B组，但三组间比较无统计学差异。随治疗时间延长，3组患儿痫样放电好转率逐渐升高。C组好转率高于B组更高于A组，组间比较差异均有统计学意义（P＜0.05）。3组患儿治疗前语言智商（VIQ）、操作智商（PIQ）及总智商（FIQ）均无显著差异，治疗后B、C两组均较治疗前得分显著升高，且高于同期A组得分，差异有统计学意义（P＜0.05）。A组不良反应发生率为28.13%，B组为12.50%，C组为3.13%，3组间比较差异显著（P＜0.05）。结论 丙戊酸钠、奥卡西平与左乙拉西坦单药治疗小儿癫痫疗效相当，但奥卡西平与左乙拉西坦对脑电功能及小儿认知功能改善具有更加积极的意义，且以左乙拉西坦的安全性更高，具有更好的应用价值。

Clinical effect and influence on congnitive reaction of single use of valproate, oxcarbazepine, and levetiracetam in treatment of children epilepsy

Objective To explore the clinical effect and influence on congnitive function of single use of valproate, oxcarbazepine, and levetiracetam in treatment of children epilepsy. Methods Children with epilepsy (96 cases) accepted in Weinan Matemty and Child Health Care Hospital from April 2011 to January 2016 were randomly divided into groups A, B, and C. Children in those three groups were given valproate, oxcarbazepine, and levetiracetam, respectively. Then the clincial efficacy, changes of EEG and congnitive function, and safety were compared. Results The total effective rates of groups A, B and C were 71.88%, 78.13%, and 90.63%, respectively, group C was little higher than groups A and B without statistically significance. The epileptiform discharge improvement rate was getting better following extended therapy. The improvement rate of group C was better than that of group B and even much better than that of group A with statistically significance (P< 0.05). The verbal IQ (VIQ), performance IQ (PIQ), and full scale IQ (FIQ) of three groups before treatment had no big difference, but the scores of groups B and C were much better than before and group A after treatment with statistically significant difference (P< 0.05). The adverse reaction rates of groups A, B, and C were 28.13%, 12.50%, and 3.13%, respectively with statistically significant difference among them (P< 0.05). Conclusion Valproate, oxcarbazepine, and levetiracetam have similar effect in treatment of children epilepsy, but oxcarbazepine and levetiracetam have positive significance in EGG and recognition function improvement. And the safety of levetiracetam is the highest of three drugs, which is worth of clincial application.