文章摘要
影响甲泼尼龙联合丙戊酸钠治疗难治性癫痫患儿疗效的因素分析
Analysis of factors affecting the efficacy of methylprednisolone combined with sodium valproate in the treatment of children with refractory epilepsy
投稿时间:2022-06-02  修订日期:2022-06-02
DOI:
中文关键词: 甲泼尼龙  丙戊酸钠  难治性癫痫  P糖蛋白  Slit-Robo GTP酶激活蛋白2  影响因素
英文关键词: methylprednisolone  sodium valproate  refractory epilepsy  P glycoprotein  Slit-Robo GTPase activator protein 2  factors
基金项目:
作者单位E-mail
万鑫 青岛市妇女儿童医院 wxin_0808@163.com 
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中文摘要:
      目的:探讨外周血P糖蛋白(P glycoprotein, P-gp)、Slit-Robo GTP酶激活蛋白2(Slit-Robo GTPase-activating proteins2, srGAP2)对甲泼尼龙联合丙戊酸钠治疗难治性癫痫患儿疗效的关系,及疗效影响因素分析。方法:本文选取2019年3月~2020年3月在我院接受治疗的140例确诊的难治性癫痫患儿,所有患儿均给予甲泼尼龙联合丙戊酸钠治疗,按疗效分为有效组和无效组。记录两组患儿的一般资料[年龄、首发年龄、性别、体重指数、病因、癫痫家族史、病程、发作类型、以往用药数量、治疗依从性、智能障碍、癫痫持续状态等]、脑电图、采用实时荧光定量PCR检测外周血P-gp、srGAP2 mRNA水平。分别采用单因素及多因素分析影响甲泼尼龙联合丙戊酸钠治疗难治性癫痫患儿疗效。结果:经治疗,140例难治性癫痫患儿中有效组患儿118例(84.29%),无效组患儿22例(15.71%)。单因素分析显示,首发年龄、发作类型、脑电图、治疗依从性、智能障碍、P-gp mRNA、srGAP2 mRNA可影响甲泼尼龙联合丙戊酸钠治疗难治性癫痫疗效(P<0.05)。Logistic多分析显示,治疗依从性、P-gp mRNA、srGAP2 mRNA是影响甲泼尼龙联合丙戊酸钠治疗难治性癫痫疗效的危险因素(P<0.05)。结论:多种因素可影响甲泼尼龙联合丙戊酸钠对难治性癫痫患儿的治疗疗效,其中依从性较差、外周血高水平P-gp及srGAP2低水平是影响疗效的危险因素。
英文摘要:
      Objective: To investigate the relationship of peripheral blood P glycoprotein (P-gp) and Slit-Robo GTPase-activating proteins2 (srGAP2) and the treatment of methylprednisolone combined with sodium valproate in children with refractory epilepsy and the factors affecting the effect. Methods: 140 children with refractory epilepsy who were treated in our hospital from March 2019 to March 2020 were selected into our study. All children were treated with methylprednisolone combined with sodium valproate, and they were divided into the effective groups and invalid groups. The general data of 2 groups [age, age at first onset, sex, body mass index, etiology, family history of epilepsy, course of disease, type of seizure, number of previous medications, treatment compliance, intellectual disability, status epilepticus, etc.]was collected. The electroencephalogram(EEG) of 2 groups was recorded. The mRNA levels of P-gp and srGAP2 in peripheral blood were detected by real-time PCR. Univariate and multivariate analysis were used to analyze the effect of methylprednisolone combined with sodium valproate in the treatment of children with refractory epilepsy. Results: After treatment, 140 children with refractory epilepsy were divided intothe effective group[118 children (84.29%)]and the ineffective group[22 children (15.71%)]. The univariate analysis showed that age of first onset, seizure type, EEG, treatment compliance, intellectual disability, P-gp mRNA, srGAP2 mRNA could affect the efficacy of methylprednisolone combined with sodium valproate in refractory epilepsy (P<0.05). Logistic multi-analysis showed that treatment compliance, P-gp mRNA and srGAP2 mRNA were risk factors affecting the efficacy of methylprednisolone combined with sodium valproate in refractory epilepsy (P<0.05). Conclusion: Various factors can affect the effect of methylprednisolone combined with sodium valproate in children with refractory epilepsy, the poor compliance, high levels of P-gp and low levels of srGAP2 in peripheral blood are the risk factors affecting the effect.
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