甲泼尼龙冲击治疗癫痫患儿的疗效及对炎症因子的影响

目的探讨甲泼尼龙冲击疗法对癫痫患儿疗效、血清炎症因子及血清高迁移率族蛋白1(high mobility group box 1,HMGB1)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)水平的影响。方法以2017-02—2019-08在开封市中心医院就诊的97例儿童癫痫为研究对象,按随机数表法分为对照组(n=48)和实验组(n=49)。对照组接受奥卡西平治疗,治疗3个疗程,实验组在对照组基础上接受甲泼尼龙冲击疗法,治疗3个疗程。评价2组临床疗效(包括脑电图、智力水平)、血清炎症因子(IL-2、TNF-α及IFN-γ)、HMGB1及GFAP的水平。结果治疗后,2组临床疗效有明显差异,实验组总有效率明显高于对照组(75.5%vs 56.3%,P<0.05);实验组脑电图改善总有效率明显高于对照组(81.6%vs 62.5%,P<0.05);治疗后2组智力均高于治疗前,且实验组言语智力、操作智力及总智力均高于对照组(t=0.012、0.006、0.001,P<0.05)。实验组血清HMGB1及GFAP水平显著低于对照组(P<0.05);同时,治疗后2组炎症IL-2、TNF-α及IFN-γ水平较前明显下降,且实验组明显低于对照组(t=0.000、0.000、0.000,P<0.05);实验组出现感染、库欣综合征等不良反应,对症处理及治疗结束后消失。结论甲泼尼龙冲击疗法治疗癫痫患儿的临床疗效更好,可减少脑电图异常波形,改善患儿智力发育等远期预后,降低血清炎症因子水平及HMGB1、GFAP水平,减少脑损伤,且不良反应较少,具有一定的临床应用价值。

Effect of methylprednisolone therapy on serum inflammatory factors in epileptic children

Objective To explore the efficacy of methylprednisolone therapy on serum inflammatory factors,high mobility group box 1(HMGB1)and glial fibrillary acidic protein(GFAP)levels in epileptic children.Methods A total of 97 children with epilepsy treated in our hospital from February 2017 to August 2019 were divided into control group(n=48)and experimental group(n=49).The control group was treated with oxcarbazepine for three courses,and the experimental group was treated with methylprednisolone on the basis of the control group for three courses.The clinical effects(including EEG,intelligence level),serum inflammatory factors(IL-2,TNF-αand IFN-γ),HMGB1 and GFAP levels were evaluated.Results After treatment,there was a significant difference in clinical efficacy between the two groups.The total effective rate of the experimental group was significantly higher than that of the control group(75.5%vs 56.3%,P<0.05);the total effective rate of EEG improvement in the experimental group was significantly higher than that of the control group(81.6%vs 62.5%,P<0.05);the intelligence of both groups after treatment was higher than that before treatment,and the speech intelligence,operation intelligence and total intelligence of the experimental group were higher than those of the control group(t=0.012,0.006 and 0.001,P<0.05).The levels of serum HMGB1 and GFAP in the experimental group were significantly lower than those in the control group(P<0.05);at the same time,the levels of inflammatory IL-2,TNF-αand IFN-γin the experiment groups after treatment were significantly lower than those in the control group(t=0.000,0.000 and 0.000,P<0.05);adverse reactions such as infection and Cushing's syndrome occurred in the experimental group and disappeared after treatment.Conclusion Methylprednisolone shock therapy has a better clinical effect in the treatment of epileptic children.It can reduce the generation of abnormal EEG waveform,improve the long-term prognosis of children's intellectual development,reduce the level of serum inflammatory factors,HMGB1 and GFAP,reduce brain damage,and have less adverse reactions.