丙戊酸钠联合左乙拉西坦治疗小儿癫痫的疗效及对TLR4/NF-κB的影响-现代医学

丙戊酸钠联合左乙拉西坦治疗小儿癫痫的疗效及对TLR4/NF-κB的影响

单位：1. 北京天使儿童医院小儿神经内科, 北京 100020;
2. 北京市博爱医院儿科, 北京 100068;
3. 首都儿科研究所儿科, 北京 100020;
4. 北京德胜门中医院中医科, 北京 100020

分类号：R742

出版年·卷·期（页码）：2018·46·第八期（915-919）

摘要：

目的：探讨丙戊酸钠联合左乙拉西坦治疗小儿癫痫脑损伤的临床疗效，及其对TLR4/NF-κB信号通路蛋白水平的改变。方法：选取本院2015年5月~2017年5月收治的120例小儿癫痫患者随机分为三组，丙戊酸钠组接受丙戊酸钠单独治疗，左乙拉西坦组接受左乙拉西坦单独治疗，联合组接受丙戊酸钠联合左乙拉西坦药物治疗半年，观察患者应用的药物疗效。采用酶联免疫吸附法检测患者治疗前后血清中通路蛋白（TLR4和NF-κB）和细胞因子（TNF-α、IL-Iβ和IL-6）的浓度变化。结果：丙戊酸钠联合左乙拉西坦治疗后，患者血清TLR4和NF-κB浓度、TNF-α、IL-Iβ和IL-6炎症因子水平明显升高，差异具有统计学意义（P<0.05）。丙戊酸钠联合左乙拉西坦治疗治疗小儿癫痫的总有效率为95.00%。结论：患者血清中TLR4/NF-κB信号通路相关蛋白的改变在临床诊断小儿癫痫的发生发展过程具有重要作用；丙戊酸钠联合左乙拉西坦治疗小儿癫痫脑损伤可能通过调节TLR4/NF-κB信号通路发挥作用。

Objective:To investigate the clinical efficacy of sodium valproate combined with levetiracetam in the treatment of brain injury in children with epilepsy and the changes in protein levels of TLR4/NF-κB signaling pathway. Methods:120 patients with pediatric epilepsy were randomly divided into three groups:group Sodium valproate received sodium valproate alone, group Levetiracetam received levetiracetam alone combination group received sodium valerate and levetiracetaman drug treatment for six months to observe the efficacy of patients with drugs. (TLR4 and NF-κB) and cytokines (TNF-α, IL-Iβ and IL-6) in serum were measured by ELISA. Results:The levels of serum TLR4 and NF-κB, TNF-α, IL-Iβ and IL-6 were significantly increased after treatment with valproate combined with levetiracetam, the difference was statistically significant (P< 0.05). The total effective rate of valproate combined with levetiracetam in the treatment of pediatric epilepsy was 95.00%.Conclusion:The changes of TLR4/NF-κB signaling pathway in serum of patients have an important role in the diagnosis and treatment of epilepsy in children. Sodium valproate combined with levetiracetam in the treatment of epilepsy in children may play a role by regulating the TLR4/NF-κB signaling pathway.

参考文献：

[1] 邹显巍,刘爱东,余建萍.自发性癫痫大鼠皮质和海马中GLT-1、EAAC-1表达[J].神经损伤与功能重建,2016,11(4):293-295.
[2] 杨倩,杨峰,刘文春,等.恩施地区儿童癫痫与共患病现状及管理策略(附238例回顾分析)[J].神经损伤与功能重建,2016,11(6):569-571.
[3] 中华医学会儿科学分会神经学组. 儿童癫痫长程管理专家共识[J].中华儿科杂志, 2013,51(9):699-703.
[4] 张淑, 芹王华, 梁峰. 癫痫大鼠海马和颞叶皮质中pleiotrophin的表达及意义[J]. 中国医科大学学报,2014,43(8):714-719
[5] EUN S H, EUN B L, LEE J S, et al. Effects of lamortigine on cognition and behavior compared to carbamazepine as monotherapy for children partial epilepsy[J]. Brain Dev, 2012,34(10):818-823.
[6] 班立丽,唐晓霞.丙戊酸钠血药浓度与抗癫痫疗效及不良反应关系研究[J].中国医院用药评价与分析,2013,13(12):1086-1089
[7] 周田,刘铮.左乙拉西坦、丙戊酸钠治疗中央棘波良性癫痫69例[J].陕西医学杂志,2011,40(4):481-483.
[8] 牟荣芳,张荣艳,贾智育.3种不同方式治疗小儿难治性癫痫的临床疗效及安全性分析[J].检验医学与临床,2017,14(1):77-79.
[9] Commission on Classification and Terminology of the International-League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures[J].Epilepsia,1981,22(4):489-501.
[10] 陶哲,伊文霞,韩颖,等.儿童癫痫发作的远期预后及相关因素[J].北京大学学报:医学版,2014,46(2):315-318.
[11] 杨春治.雷公藤内酯醇对大鼠变应性鼻炎TLR2-NF-κB信号通路的干预作用[J].山西医科大学学报,2015,46(7):636-640.
[12] 欧阳龙强,梁日生,杨卫忠.TLR4信号转导通路与癫痫的研究进展[J].中国免疫学杂志,2012,28(1):88-90.
[13] 宋炜,蔡鹏,杜雷,等.丙泊酚对癫痫大鼠学习记忆及海马TLR4表达的影响[J].中国药理学通报,2014,30(12):1725-1729.
[14] 郭电渠,王新军,杨如意,等.癫痫患者血清HMGBI及其受体TLR4水平及临床意义分析[J].中华神经医学杂志,2016,15(9):936-940.
[15] 武强,黎红华,濮捷,等.丙戊酸钠注射液联合左乙拉西坦治疗难治性癫痫持续状态的临床观察[J].临床军医杂志,2013,41(6):608-610.
[16] 王维,陈兴旺,陈春富,等.左乙拉西坦预防难治性偏头痛的疗效及安全性[J].中国神经精神疾病杂志,2014,40(3):172-175.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录