| 摘要: |
| 目的:探讨常用抗癫痫药物联合维生素B12 、叶酸对癫痫患儿血清同型半胱氨酸(Hcy)、血氨水平的影响。方法:选取河
北省人民医院2015 年1 月至2018 年2 月收治的癫痫患儿270 例,根据不同口服抗癫痫药物(AEDs)分为单纯奥卡西平组65 例,单
纯丙戊酸钠组65 例,奥卡西平联合维生素B12 / 叶酸组70 例,丙戊酸钠联合维生素B12 / 叶酸组70 例。干预3 个月后,检测患儿
血清Hcy、血氨、维生素B12 、叶酸水平。观察治疗前后患儿生活质量,焦虑、抑郁、负面情绪等改善效果,随访1 年统计复发率和
复发时间。结果:治疗后,奥卡西平联合维生素B12 / 叶酸组和丙戊酸钠联合维生素B12 / 叶酸组总有效率分别为94.3% 和
92.9%,高于单纯奥卡西平组和单纯丙戊酸钠组(P<0.05)。治疗后,奥卡西平联合维生素B12 / 叶酸组、丙戊酸钠联合维生素
B12 / 叶酸组高血清Hcy、高血氨的比例低于单纯奥卡西平组、单纯丙戊酸钠组(P<0.05),奥卡西平联合维生素B12 / 叶酸组和丙
戊酸钠联合维生素B12 / 叶酸组以及单纯奥卡西平组和单纯丙戊酸钠组组间Hcy、血氨水平比较差异无统计学意义(P>0.05)。
四组治疗前后脑电图δ波、θ波、ɑ波、β波各频段占比组内、组间比较差异均无统计学意义（P>0.05）。奥卡西平联合维生素B12/叶酸组、丙戊酸钠联合维生素B12/叶酸组治疗后生活质量量表-31（QOLIE-31）评分高于单纯奥卡西平组、单纯丙戊酸钠组，汉密尔顿焦虑量表（HAMD）、汉密尔顿抑郁量表（HAMA）评分低于单纯奥卡西平组、单纯丙戊酸钠组（P<0.05）。治疗后随访1年，奥卡西平联合维生素B12/叶酸组、丙戊酸钠联合维生素B12/叶酸组复发率、复发时间均低于或短于单纯奥卡西平组、单纯丙戊酸钠组（P<0.05）。结论：抗癫痫药物联合补充维生素B12和叶酸治疗癫痫患儿可降低患儿血清Hcy、血氨水平，提高治疗效果，改善脑电图状况，提高生活质量，降低心理不良情绪，且不会增加不良反应。 |
| 关键词: 奥卡西平 丙戊酸钠 维生素B12 叶酸 癫痫 同型半胱氨酸 |
| DOI：doi:10.13407/ j.cnki.jpp.1672.108X.2022.04.010 |
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| 基金项目:河北省卫生计生委重点课题计划项目，编号20170256。 |
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| Efficacy of Antiepileptic Drugs Combined with Vitamin B12 and Folic Acid in the Treatment of Epilepsy inChildren and Effects on Serum Homocysteine and Blood Ammonia Levels |
| Sun Meng, Wang Xin, Zhou Ran, Zheng Youning, Cheng Yaying |
| (Hebei General Hospital, Shijiazhuang 050051, China) |
| Abstract: |
| Objective: To probe into the effects of common antiepileptic drugs combined with vitamin B12 and folic acid on serum
homocysteine (Hcy) and blood ammonia levels in children with epilepsy. Methods: A total of 270 children with epilepsy admitted into
Hebei General Hospital from Jan. 2015 to Feb. 2018 were selected. According to different oral antiepileptic drugs (AEDs), all patients
were divided into 65 cases in the single oxcarbazepine group, 65 cases in the single sodium valproate group, 70 cases in the
oxcarbazepine combined with vitamin B12 / folic acid group, and 70 cases in the sodium valproate combined with vitamin B12 / folic acid
group. After 3 months of intervention, serum Hcy, blood ammonia, vitamin B12 and folic acid levels were detected. The quality of life,
anxiety, depression and negative emotions of the children before and after treatment were observed, and the recurrence rate and
recurrence time were counted in the follow-up for 1 year. Results: After treatment, the total effective rates of oxcarbazepine combined
with vitamin B12 / folic acid group and sodium valproate combined with vitamin B12 / folic acid group were respectively 94.3% and
92.9%, higher than those of the single oxcarbazepine group and single sodium valproate group (P <0.05). After treatment, the
proportions of high serum Hcy and high blood ammonia in oxcarbazepine combined with vitamin B12 / folic acid group and sodium
valproate combined with vitamin B12 / folic acid group were lower than those in single oxcarbazepine group and single sodium valproate
group (P<0.05). There were no significant differences in Hcy and blood ammonia levels between the oxcarbazepine combined with
vitamin B12 / folic acid group and sodium valproate combined with vitamin B12 / folic acid group, and between the single oxcarbazepine
group and single sodium valproate group (P>0.05). Groups of eeg before and after the treatment the delta, beta, theta, ɑ wave spectrum proportion within the group, group comparison between no statistical significance (P>0.05). After treatment, QOLIE-31 scores in observation group 1 and observation group 2 were higher than those in oxapine group and valproate group, and HAMD and HAMA scores were lower than those in oxapine group and valproate group (P<0.05). Follow-up after treatment for one year showed that the recurrence rate and time of recurrence in group 1 and group 2 were lower than those in oxacepine group and valproate group (P<0.05). Conclusion: Antiepileptic drugs combined with vitamin B12 and folic acid supplementation can reduce the blood Hcy and blood ammonia content in children with epilepsy, improve the treatment effect, improve the eeg status, improve the quality of life, reduce the psychological adverse mood, and do not increase the incidence of adverse reactions. |
| Key words: oxcarbazepine valproate vitamin B12 epilepsy homocysteine electroencephalogram |
