Zhang Dongli, Qiu Li, Zhang Yuan, Sang Yan, Zheng Nuo, Liu Xiaoming
Department of Neurology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221000, P.R. China.
Exp Ther Med. 2020 Sep;20(3):2698-2704. doi: 10.3892/etm.2020.8984. Epub 2020 Jul 10.
Efficacy and safety of sodium valproate (SV) and lamotrigine (LTG) in treating refractory epilepsy (RE) in children and the predictive value of serum neuron-specific enolase (NSE) and central nervous system specific S100β protein (S100β) on efficacy assessment were explored. A total of 110 RE children admitted to Xuzhou Children's Hospital, Xuzhou Medical University were enrolled. Patients treated with SV alone served as the control group (n=51), and those treated with SV plus LTG as the study group (n=59). Serum NSE and S100β expression levels were measured by enzyme-linked immunosorbent assay (ELISA). The efficacy, seizure frequency, adverse reactions, concentration of serum brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF), and expression of serum NSE and S100β were observed and compared. The total effective rate in the study group was significantly higher than that in the control group, and the seizure frequency and incidence of adverse reactions were significantly lower than that in the control group. The study group showed remarkably higher BDNF and NGF than the control group after treatment. The expression of serum NSE and S100β in effectively treated children were significantly lower than that in ineffectively treated children. The area under the curve (AUC) of serum NSE and S100β were 0.828 and 0.814 respectively. SV combined with LTG is better and safer than SV alone in the treatment of RE in children. Serum NSE and S100β are of high value in predicting the efficacy.
探讨丙戊酸钠（SV）与拉莫三嗪（LTG）治疗儿童难治性癫痫（RE）的疗效及安全性，以及血清神经元特异性烯醇化酶（NSE）和中枢神经系统特异性S100β蛋白（S100β）对疗效评估的预测价值。选取徐州医科大学附属徐州儿童医院收治的110例RE患儿。单纯使用SV治疗的患者作为对照组（n = 51），使用SV联合LTG治疗的患者作为研究组（n = 59）。采用酶联免疫吸附测定（ELISA）法检测血清NSE和S100β表达水平。观察并比较两组的疗效、癫痫发作频率、不良反应、血清脑源性神经营养因子（BDNF）和神经生长因子（NGF）浓度以及血清NSE和S100β表达。研究组的总有效率显著高于对照组，癫痫发作频率和不良反应发生率显著低于对照组。治疗后，研究组的BDNF和NGF显著高于对照组。有效治疗患儿的血清NSE和S100β表达显著低于无效治疗患儿。血清NSE和S100β的曲线下面积（AUC）分别为0.828和0.814。SV联合LTG治疗儿童RE比单用SV疗效更好且更安全。血清NSE和S100β对疗效预测具有较高价值。
