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目的:探讨托吡酯与丙戊酸钠对癫痫患儿脑电活动及相关代谢指标的影响。方法:选择66例癫痫患儿进行研究,并采用随机方法分为两组,其中观察组予托吡酯治疗,对照组予丙戊酸钠治疗。比较治疗前后患儿脑电活动及糖脂代谢指标差异。结果:治疗后,观察组患儿癫痫样放电(6.77±1.04)次、δ(12.77±2.32)次、θ(21.63±2.77)次、α(20.54±2.55)次、β(11.18±1.72)次均较治疗前和对照组明显减少(P<0.05)。观察组患儿经治疗后体质指数(BMI)(14.43±1.29)kg/m2、空腹血糖(FPG)(4.53±0.51)mmol/L较治疗前和对照组明显减少(P<0.05),空腹胰岛素(FINS)(9.78±1.44)m U/L较治疗前和对照组明显增加(P<0.05)。两组患者经治疗后脂代谢各项指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(L-DLD)、高密度脂蛋白(H-DLD)均较治疗前无明显变化(P>0.05),且两组间比较无显著差异(P>0.05)。结论:托吡酯能更有效控制癫痫患儿的脑电活动,但会导致糖代谢异常及患儿体质量指数减少,而丙戊酸钠对癫痫患儿糖脂代谢及体质量指数的影响较小,临床应根据具体情况合理选择用药。
Objective: To investigate the effects of topiramate and valproate on the electrophysiological activities and related metabolic parameters in children with epilepsy. Methods: Sixty-six children with epilepsy were selected and divided into two groups randomly. The observation group was treated with topiramate and the control group was treated with sodium valproate. The difference of EEG activity and glucose and lipid metabolism between children before and after treatment was compared. Results After treatment, the incidences of epileptiform discharge (6.77 ± 1.04), δ (12.77 ± 2.32), θ (21.63 ± 2.77), α (20.54 ± 2.55), β (11.18 ± 1.72) Compared with pre-treatment and control group, they were significantly decreased (P <0.05). The BMI (14.43 ± 1.29) kg / m2 and FPG (4.53 ± 0.51) mmol / L in the observation group were significantly decreased (P <0.05) compared with those before treatment and the control group. Fasting insulin (FINS) (9.78 ± 1.44) mU / L was significantly higher than that before treatment and the control group (P <0.05). The TG, TC, L-DLD and H-DLD in the two groups of patients after treatment did not change significantly compared with those before treatment (P> 0.05), and there was no significant difference between the two groups (P> 0.05). CONCLUSION: Topiramate can effectively control the electroencephalogram in children with epilepsy, but it can lead to abnormal glucose metabolism and decrease of body mass index in children with epilepsy. However, the effect of sodium valproate on blood glucose and lipid metabolism and body mass index in children with epilepsy is small, Clinical should be based on the specific circumstances of a reasonable choice of medication.