李婉婉;赵少聪;贾东华;梅道启;唐志慧;孙晓敏;

• 1:郑州大学附属儿童医院河南省儿童医院郑州儿童医院

摘要(Abstract)：

目的观察奥拉西坦治疗儿童癫痫伴有认知功能障碍的临床疗效。方法选取2017-01-2019-12郑州儿童医院50例临床诊断癫痫且伴随认知功能障碍的患儿,随机分为对照组(常规抗癫痫治疗)、观察组(常规治疗的基础上给予奥拉西坦口服),统计分析2组治疗前后MMSE评分、MoCA评分变化状况、认知障碍改善效果及不良反应发生率。结果治疗前2组患儿MMSE、MoCA评分比较,差异均无统计学意义(P>0.05);治疗后2组患儿MMSE、MoCA评分均优于本组治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。观察组总有效率为92%,高于对照组的68%,差异有统计学意义(P<0.05);2组均无明显不良反应。结论奥拉西坦治疗儿童癫痫伴认知功能障碍,能更好的促进患儿认知功能的恢复,且无明显不良反应。

关键词(KeyWords)： 奥拉西坦;儿童;癫痫;认知功能障碍

Abstract:

Keywords:

基金项目(Foundation): 河南省科技攻关项目(编号:2018020633)

作者(Authors): 李婉婉;赵少聪;贾东华;梅道启;唐志慧;孙晓敏;

参考文献(References)：

• [1] BOTTINI G,WALLAT G,CAPPA S,et al.Oxiracetam in dementia:a double-blind,placebo-controlled study[J].Acta Neurol Scand,1992,86:237-241.
• [2] LI W,LIU H,JIANG H,et al.(S)-Oxiracetam is the Active Ingredient in Oxiracetam that Alleviates the Cognitive Impairment Induced by Chronic Cerebral Hypoperfusion in Rats[J].SciRep,2017,7(1):10052.
• [3] HUANG L,SHANG E,FAN W,et al.S-oxiracetam protect against ischemic stroke via alleviating blood brain barrier dysfunction in rats[J].Eur J Pharm Sci,2017,109:40-47.
• [4] SUN Y,XU B,ZHANG Q.Nerve growth factor in combination with Oxiracetam in the treatment of Hypertensive Cerebral Hemorrhage[J].Pak J Med Sci,2018,34(1):73-77.
• [5] WANG J,SUN R,LI Z,et al.Combined bone marrow stromal cells and oxiracetam treatments ameliorates acute cerebral ischemia/reperfusion injury through TRPC6[J].Acta Biochim Biophys Sin,2019,51(8):767-777.
• [6] XU J,QI Q,LV P,et al.Oxiracetam ameliorates cognitive deficits invascular dementia rats by regulating the expression of neuronal apoptosis/autophagy-related genes associated with the activation of the Akt/mTOR signalingpathway[J].BrazJ Med Biol Res,2019,52(11):e8371.
• [7] 逯艳梅.丙戊酸钠与奥卡西平治疗儿童癫痫的疗效比较[J].中国实用神经疾病杂志,2018,21(15):1675-1679.
• [8] BOTTINI G,VALLAR G,CAPPA S,et al.Oxiracetam in dementia:a double-blind,placebo-controlled study[J].Acta Neurol Scand,1992,86(3):237-241.
• [9] ZHANG Q,YANG W,ZHANG Q,et al.Enantioselective HPLC determination of oxiracetam enantiomers and application to a pharmacokinetic study in beagle dogs[J].J Chromatogr B Analyt Technol Biomed Life Sci,2015,993-994:9-13.
• [10] HLINáK Z,KREJCí I.Oxiracetam prevents the MK-801 induced amnesia for the elevated plus-maze in mice[J].Behav Briain Res,2000,117(1/2):147-51.
• [11] ZARNOWSKA E D,RODGERS F C,OH I,et al.Etomidate blocks LTP and impairs learning but does not enhance tonic inhibition in mice carrying the N265M point mutation in the beta3 subunit of the GABA(A) receptor[J].Neuropharmacology,2015,93:171-178.
• [12] SUN M L,SHI D M,YIN H N,et al.Quantitative EEG and event-related potential P300 analysis oxiracetam injection curative effect in the treatment of delayed encephalopathy after acutecarbon monoxide poisoning[J].Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi,2018,36(2):158-160.
• [13] FAN W,LI X,HUANG L,et al.S-oxiracetam ameliorates ischemic stroke induced neuronal apoptosis through up-regulating α7 nAChR and PI3K/Akt/GSK3β signal pathway in rats[J].Neurochem Int,2018,115:50-60.
• [14] YA O,X L,YAO Z H,LI L,et al.Oxiracetam can improve cognitive impairment after chronic cerebral hypoperfusion in rats[J].Psychiatry Res,2016,246:284-292.
• [15] SANTOS A R,MELE M,VAZ S H,et al.Differential role of the proteasome in the early and late phases of BDNF-induced facilitation of LTP[J].J Neurosci,2015,35(8):3319-3329.
• [16] HLINáK Z,KREJCí I.Oxiracetam prevented the scopolamine but not the diazepam induced memory deficits in mice[J].Behav Briain Res,2002,18:133(2):395-399.
• [17] MALYKL A G,SADAIE M R.Piracetam and piracetam-like drugs:from basic science to novel clinical applications to CNS disorders[J].Drugs,2010,70(3):287-312.
• [18] LI X,HU X,WANG J,et al.Inhibition of autophagy via activation of PI3K/Akt/mTOR pathway contributes to the protection of hesperidin against myocardial ischemia/reperfusion injury[J].Int J Mol Med,2018,42:1917-1924.
• [19] HANG P,ZHAO J,SU Z,et al.Choline Inhibits ischemia-reperfusion-induced cardiomyocyte autophagy in rat myocardium by activating Akt/mTOR signaling[J].Cell Physiol Biochem,2018,45:2136-2144.
• [20] SONG Y,LIU W,DING Y,et al.Salvianolic acid A ameliorates renal ischemia/reperfusion injury by activating Akt/mTOR/4EBP1 signaling pathway[J].Am J Physiol Renal Physiol,2018,315:F254-F262.
• [21] YAN B C,WANG J,RUI Y,et al.Neuroprotective effects of gabapentin against cerebral ischemia reperfusion-induced neuronal autophagic injury via regulation of the PI3K/Akt/mTOR signaling pathways[J].J Neuropathol Exp Neurol,2019,78:157-171.
• [22] WANG C,LI F,CUAN Y,et al.Bone marrow stromal cells combined with oxiracetam influences the expression of B-cell lymphoma 2 in rats with ischemic stroke[J].J Stroke Cerebrovasc Dis,2014,23(10):2591-2597.
• [23] BARSOTTI C L,IPATA P L.Metabolic regulation of ATP breakdown and of adenosine production in rat brain extracts[J].Int J Biochem Cell Biol,2004,36(11):2214-2225.
• [24] PACKER R M A,MCGREEVY P D,SALVIN H E,et al.Cognitive dysfunction in naturally occurring canine idiopathic epilepsy[J].PLoS One,2018,13(2):e0192182.
• [25] RATCLIFFE C,WANDSCHNEIDER B,BAXENDALE S,et al.Cognitive Function in Genetic Generalized Epilepsies:Insights From Neuropsychology and Neuroimaging[J].Front Neurol,2020,11:144.