陈竹,余静,赵荣香
CHEN Zhu,YU Jing,ZHAO Rongxiang

• 1:绵阳市中心医院儿科

摘要(Abstract)：

目的:分析高热患儿间断口服左乙拉西坦(LEV)预防复杂型热性惊厥(CFS)的效果及安全性。方法:收集有2次或2次以上热性惊厥(FS)发作史的热性惊厥患儿160例,其中单纯型热性惊厥(SFS组)130例、CFS组30例,SFS组70例患儿给予LEV治疗、60例给予常规治疗,CFS组16例患儿给予LEV治疗,14例给予常规治疗,比较两种治疗方式的有效率及FS复发率;比较CFS组患儿治疗前后血清神经元特异性烯醇化酶(NSE)、S-100β蛋白(S-100β)及脑源性神经营养因子(BDNF)水平;应用韦氏儿童智力量表(C-WISC)、儿童适应行为评定量表第Ⅱ版(ABAS-Ⅱ)评估CFS组患儿治疗前后的智商及行为能力,并观察不良反应。结果:SFS组患儿LEV治疗有效率、总治疗有效率与CFS组比较差异无统计学意义(P>0.05),SFS组、CFS组患儿LEV治疗有效率均高于常规治疗,CFS组患儿LEV治疗复发率低于SFS组,差异有统计学意义(P<0.05);CFS患儿中,LEV治疗组患儿治疗后血清NSE、S-100β、BDNF水平明显低于常规治疗组,LEV治疗组患儿治疗后C-WISC评分、ABAS-Ⅱ评分明显高于常规治疗组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:高热患儿间断口服LEV预防CFS疗效确切,在减少CFS复发同时,提升其免疫功能、智商及行为能力。
Objective: To analyze the effects and safety of intermittent oral administration of levetiracetam( LEV) for prevention of complex febrile seizure( CFS) in children with high fever. Methods:One hundred and sixty children with febrile seizure( FS) who had 2 or more episodes before were chosen,including 130 cases of simple febrile seizure( group SFS) and 30 cases of CFS( group CFS). In group SFS,70 cases were given with LEV and 60 cases with routine therapy,while in group CFS 16 cases were given with LEV and 14 cases with routine therapy. The effective rate and FS recurrence rate of the two treatment methods were compared,and the levels of serum neuron specific enolase( NSE),S-100 β protein( S-100β),and brain-derived neurotrophic factor( BDNF) in group CFS before and after treatment were compared. Wechsler Intelligence Scale for Children( C-WISC) and children's Adaptive Behavior Rating Scale Ⅱ( ABAS-Ⅱ) were used to assess intelligence quotient and behavior ability in group CFS before and after treatment,and adverse reactions were observed. Results: There was no significant difference in LEV treatment effective rate and total treatment effective rate between groups SFS and CFS( P > 0. 05). In both groups the effective rate of LEV treatment was higher than that of routine treatment( P < 0. 05),and the recurrence rate of LEV in group CFS was lower than that in group SFS( P < 0. 05). In group CFS,after treatment,the levels of serum NSE,S-100β and BDNF of children treated with LEV were significantly lower than those of children with routine therapy,while their scores of C-WISC and ABAS-Ⅱ were significantly higher than those of children with routine therapy( P < 0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusions: Intermittent oral administration of LEV might prevent CFS with an exact efficacy in children with high fever,and can reduce the CFS recurrence and enhance their immune function,IQ,and behavioral ability.

关键词(KeyWords)： 恶性高热;左乙拉西坦;惊厥;发热性;安全性;预防
high fever;levetiracetam;seizure;fever;safety;prevention

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生厅(1202261)

作者(Author): 陈竹,余静,赵荣香
CHEN Zhu,YU Jing,ZHAO Rongxiang

DOI: 10.19367/j.cnki.1000-2707.2018.01.021

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