摘要
目的探讨持续性静脉泵入咪达唑仑对癫痫持续状态(SE)小儿血神经肽Y(NPY)、甘丙肽(GAL)、脑源性神经营养因子(BDNF)的影响。方法采用前瞻性研究方法,选取2017年2月至2019年10月海南医学院第二附属医院收治的94例SE患儿,按照随机数字表法将其分为两组:对照组和观察组,每组各47例。对照组患者给予地西泮治疗,观察组患者给予咪达唑仑治疗。比较两组患者的临床疗效、惊厥控制时间、停药后完全恢复清醒状态时间、癫痫持续状态严重程度评分(STESS)、血炎症因子[白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、NPY、GAL、BDNF水平、不良反应情况。采用Pearson相关性分析评价各指标与STESS评分的相关性。结果观察组显效率(82.98%)高于对照组(53.19%),惊厥控制时间(43.56±11.09 min)、停药后完全恢复清醒状态时间(5.59±1.28 h)均明显短于对照组(58.79±13.25 min,7.47±1.53 h),STESS评分(0.84±0.25分)低于对照组(1.22±0.39分),差异均具有统计学意义(P<0.05);治疗后,观察组患者的IL-1(10.19±2.55 pg/ml)、TNF-α(12.28±2.47 pg/ml)、IL-6(13.16±1.49 pg/ml)、NPY(149.35±16.27 ng/L)、GAL(68.30±12.77 ng/L)、BDNF(0.76±0.18 ng/ml)均低于对照组(14.73±3.12 pg/ml,19.35±4.01 pg/ml,17.39±2.44 pg/ml,208.19±20.35 ng/L,89.46±13.02 ng/L,1.08±0.27 ng/ml),差异具有统计学意义(P<0.05);治疗前后血清IL-1(r=0.599)、TNF-α(r=0.429)、IL-6(r=0.617)、NPY(r=0.571)、GAL(r=0.456)、BDNF(r=0.622)变化与STESS评分呈正相关(P<0.05)。结论持续性静脉泵入咪达唑仑治疗SE,可通过下调IL-1、TNF-α、IL-6、NPY、GAL、BDNF发挥显著的疗效。
Objective To investigate the effects of continuous intravenous pumping of Midazolam on serum neuropeptide Y(NPY),galanin(GAL),and brain-derived neurotrophic factor(BDNF)in children with status epilepicus(SE).Methods Using prospective research methods,94 children with SE admitted to the Second Affiliated Hospital of Hainan Medical College from February 2017 to October 2019 were selected,and they were divided into two groups according to the random number table method:the control group and the observation group,with 47 cases in each group.The control group was given Diazepam and the observation group was given Midazolam.The clinical efficacy,seizure control time,time to complete recovery to awake state after discontinuation of medication,the Status Epilepticus Severity Score(STESS),blood inflammatory factors[interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],NPY,GAL,BDNF levels and adverse reactions between the two groups were compared,and the correlation between blood indexes and STESS score was analyzed by Pearson correlation analysis.Results The efficiency of the observation group(82.98%)was higher than that of the control group(53.19%),the seizure control time(43.56±11.09 min)and the time to complete recovery to awake state after discontinuation of medication(5.59±1.28 h)were significantly shorter than those of the control group(58.79±13.25 min,7.47±1.53 h),and the STESS(0.84±0.25 points)was lower than that of the control group(1.22±0.39 points),and the differences were statistically significant(P<0.05);after treatment,IL-1(10.19±2.55 pg/ml),TNF-α(12.28±2.47 pg/ml),IL-6(13.16±1.49 pg/ml),NPY(149.35±16.27 ng/L),GAL(68.30±12.77 ng/L)and BDNF(0.76±0.18 ng/ml)of the observation group were lower than those of the control group(14.73±3.12 pg/ml,19.35±4.01 pg/ml,17.39±2.44 pg/ml,208.19±20.35 ng/L,89.46±13.02 ng/L,1.08±0.27 ng/ml),the differences were statistically significant(P<0.05);IL-1(r=0.599),TNF-α(r=0.429),IL-6(r=0.617),NPY(r=0.571),GAL(r=0.456),BDNF(r=0.622)before and after treatment were positively correlated with STESS score(P<0.05).Conclusion Continuous intravenous pumping of Midazolam plays a significant role in the treatment of SE by down-regulating IL-1,TNF-α,IL-6,NPY,GAL and BDNF.
作者
陈石娇
陈运旺
陈妮
雷智贤
CHEN Shi-jiao;CHEN Yun-wang;CHEN Ni(Department of Pediatrics,the Second Affiliated Hospital of Hainan Medical College,Haikou Hainan 570311,China)
出处
《临床和实验医学杂志》
2020年第14期1552-1556,共5页
Journal of Clinical and Experimental Medicine
基金
海南省自然科学基金(编号:813245)。
