拉莫三嗪联合维生素B12对小儿脑瘫合并癫痫患儿氨基酸代谢与脑电图的影响

Effects of lamotrigine combined with vitamin B12 on amino acid metabolism and electroencephalogram in children with cerebral palsy complicated by epilepsy

摘要:

目的 探讨拉莫三嗪联合维生素B12对小儿脑瘫合并癫痫患儿的氨基酸代谢指标及脑电图（EEG）的影响。方法 回顾性分析2022年4月—2023年10月江苏大学附属医院治疗的83例小儿脑瘫合并癫痫患儿的临床资料，按治疗方法分为对照组41例（拉莫三嗪治疗）和联合组42例（拉莫三嗪联合维生素B12治疗）。分析两组患儿治疗前后的脑电图（EEG）δ波、θ波、α波、β波的相对功率；采用韦氏儿童智力量表（WISC-CR）评估患儿认知功能，包括全面智力指数（FIQ）、言语智力指数（VIQ）、操作智力指数（PIQ）；比较两组患儿治疗前后的氨基酸代谢指标［冬氨酸（Asp）、谷氨酸（Glu）、甘氨酸（Gly）］，血清炎症因子指标［白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）］，以及治疗后的不良反应。结果 联合组治疗前后θ波的差值大于对照组（P <0.05）。联合组治疗前后FIQ、VIQ和PIQ的差值均大于对照组（P <0.05）。联合组治疗前后Asp、Glu、Gly的差值绝对值大于对照组（P <0.05）。联合组治疗前后IL-6、IL-1β和TNF-α的差值均大于对照组（P <0.05）。联合组与对照组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 拉莫三嗪联合维生素B12治疗小儿脑瘫合并癫痫，能有效改善氨基酸代谢失衡和血清炎症因子水平，提高认知功能。

Abstract:

Objective To investigate the effects of lamotrigine combined with vitamin B12 on amino acid metabolism and electroencephalogram (EEG) parameters in children with cerebral palsy complicated by epilepsy.Methods A total of 83 children with cerebral palsy and epilepsy were retrospectively enrolled and divided into a control group (lamotrigine treatment, n = 41) and a combination group (lamotrigine combined with vitamin B12 treatment, n = 42). EEG parameters (relative power of δ, θ, α, and β waves), cognitive function (assessed using the Wechsler Intelligence Scale for Children-Chinese Revised, WISC-CR, including full-scale intelligence quotient [FIQ], verbal intelligence quotient [VIQ], and performance intelligence quotient [PIQ] ), amino acid metabolism indices (aspartic acid [Asp], glutamic acid [Glu], glycine [Gly] ), serum inflammatory cytokines (IL-6, IL-1β, TNF-α), and incidence of adverse reactions were analyzed before and after treatment.Results The combination group demonstrated significantly greater reductions in θ wave activity compared to the control group (P < 0.05). More pronounced improvements were observed in full-scale IQ (FIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores in the combination group versus controls (P < 0.05). Significant between-group differences were noted in the changes of aspartic acid (Asp), glutamic acid (Glu), and glycine (Gly) levels (P < 0.05). The combination group showed greater reductions in IL-6, IL-1β, and TNF-α levels than the control group (P < 0.05). No statistically significant difference was found in total adverse event incidence between groups (P > 0.05).Conclusion The combination of lamotrigine and vitamin B12 effectively improves amino acid metabolic balance, reduces inflammatory cytokine levels, and enhances cognitive function in children with cerebral palsy complicated by epilepsy.