摘要
目的 探讨高压氧联合奥卡西平治疗病毒性脑炎继发癫痫患儿的临床疗效及其作用机制.方法 选取2020年6月至2023年6月陕西省汉中市中心医院儿科收治的104例病毒性脑炎继发癫痫患儿作为研究对象.按照随机数字表法分为对照组和观察组,每组52例.比较2组患儿治疗后的临床疗效;采用简易智力状态检查量表(MMSE)评估患儿治疗前后神经功能的变化.分别于治疗前后采集患儿空腹静脉血3 ml,采用酶联免疫吸附法检测血清白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、血管细胞黏附分子-1(VCAM-1)和胶质纤维酸性蛋白(GFAP)的水平.结果 观察组患者治疗总有效率(96.15％)明显高于对照组(80.77％),差异有统计学意义(x2=4.029,P=0.014).与治疗前比较,2组患者治疗后MMSE评分明显升高,且治疗后观察组MMSE评分明显高于对照组(P＜0.01).与治疗前比较,2组患者治疗后血清IL-6、IL-8、TNF-α、VCAM-1、GFAP水平明显降低,且治疗后观察组均明显低于对照组(P＜0.01).结论 高压氧联合奥卡西平治疗病毒性脑炎继发癫痫患儿通过有效抑制血管炎症反应,修复神经功能损伤,从而提高临床治疗效果.
Abstract
Objective To investigate the clinical efficacy of hyperbaric oxygen combined with Oxcarbazepine on 52 pediatric patients with epilepsy secondary to viral encephalitis.Methods A total of 104 children with epilepsy secondary to viral encephalitis treated in the Department of Pediatrics of Hanzhong Central Hospital from June 2020 to June 2023 were selected as the study objects.According to the random number table method,those patients were divided into control group and observation group,with 52 cases in each group.The clinical efficacy of the two groups was compared after treatment,and the changes of neurological function before and after treatment were assessed by mini-mental state examination(MMSE).Before and after treatment,3 mL of fasting venous blood was taken and serum levels of interleukin(IL)-6,IL-8,tumor necrosis factor-α(TNF-α),vascular cell adhesion molecule-1(VCAM-1),and glial fibrillary acidic protein(GFAP)were detected by enzyme-linked immunosorbent assay.Results After treatment,the total effective rate of the observation group(96.15％)was significantly higher than that of the control group(80.77％),and the difference was statistically significant(x2=4.029,P=0.014).After treatment,MMSE scores of the two groups were significantly increased,and the MMSE score of the observation group was significantly higher than that of the control group(P＜0.01).After treatment,serum levels of IL-6,IL-8,TNF-α,VCAM-1,and GFAP in the two groups were significantly decreased,and the indexes of the observation group were all significantly lower than those of the control group(P＜0.01).Conclusion Hyperbaric oxygen combined with Oxcarbazepine in the treatment of epilepsy secondary to viral encephalitis can effectively inhibit vascular inflammation reactions and repair nerve function damage,thereby improving clinical efficacy.
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