Li Bin, Wu Youjia, He Qingjuan, Zhou Hui, Cai Jin
Department of Pediatrics, Affiliated Hospital of Nantong University, Nantong, China.
Transl Pediatr. 2021 Feb;10(2):394-405. doi: 10.21037/tp-20-458.
This study aimed to explore the effects of complex febrile seizures on hippocampal function and the significance of antiepileptic therapy.
A total of 150 children with complex febrile seizures admitted to our hospital from July 2017 to July 2020 were included in the study. The VPA group was given sodium valproate treatment; the LEV group was given levetiracetam treatment; and the observation group was given basic treatment. The efficacy of the patients was evaluated after medication. A complex febrile seizure young mouse model was constructed, and the hippocampal cell morphology and BCL-2 expression of the mice pups were analyzed. A Morris water maze was used to detect the changes in cognitive function of the young mice with complex febrile seizures.
After treatment, the recurrence-free rate of the VPA group was significantly higher than that of the observation group (P=0.0045). After 1 month and 6 months, the improvement rate of EEG in VPA group was significantly higher than that in observation group (P<0.05). After treatment, the levels of BCL-2 in the VPA group and the LEV group decreased and were significantly lower than the observation group during the same period (P<0.05), and the M/C of the two groups was significantly higher than the observation group (P<0.05). The neuronal cells in the hippocampus of the young rats in the VPA group and the LEV group were regular, the matrix was more uniform, and nuclear pyknotic cells were occasionally seen. The pathological changes were less obvious than the model group, followed by the degree of pathological changes (0.92±1.31, 0.94±1.24). The incubation period of pups in the model group was significantly higher than that of the normal group, VPA group, and LEV group (P<0.05), and the number of crossing the station area was significantly less than that of the normal group, VPA group, and LEV group (P<0.05).
Antiepileptic drugs are effective in preventing the recurrence of complicated febrile seizures (CFS), and the main mechanism may be related to the targeted regulation of BCL-2 on the apoptosis of the hippocampus in the nervous system.
本研究旨在探讨复杂性热性惊厥对海马功能的影响及抗癫痫治疗的意义。
选取2017年7月至2020年7月我院收治的150例复杂性热性惊厥患儿纳入研究。丙戊酸钠组给予丙戊酸钠治疗；左乙拉西坦组给予左乙拉西坦治疗；观察组给予基础治疗。用药后评估患者疗效。构建复杂性热性惊厥幼鼠模型，分析幼鼠海马细胞形态及BCL-2表达。采用Morris水迷宫检测复杂性热性惊厥幼鼠认知功能变化。
治疗后，丙戊酸钠组无复发率显著高于观察组（P = 0.0045）。治疗1个月和6个月后，丙戊酸钠组脑电图改善率显著高于观察组（P < 0.05）。治疗后，丙戊酸钠组和左乙拉西坦组BCL-2水平下降，且同期显著低于观察组（P < 0.05），两组M/C显著高于观察组（P < 0.05）。丙戊酸钠组和左乙拉西坦组幼鼠海马神经元细胞排列规则，基质较均匀，偶见核固缩细胞。病理改变较模型组轻，病理改变程度依次为（0.92±1.31，0.94±1.24）。模型组幼鼠潜伏期显著高于正常组、丙戊酸钠组和左乙拉西坦组（P < 0.05），穿越站台区次数显著少于正常组、丙戊酸钠组和左乙拉西坦组（P < 0.05）。
抗癫痫药物对预防复杂性热性惊厥复发有效，主要机制可能与BCL-2对神经系统海马凋亡的靶向调控有关。
