| Objective: To compare with three antiepileptic drugs,such as valproate(VPA),levetiracetam(LEV),topiramate(TPM),were used to compare the efficacy,adverse reactions and EEG of Complex ferbrile seizures in children with recurrence secondary epilepsy risk factors.Providing necessary help and guidance on the choice of drugs for the pediatricians in children with complex ferbrile seizures to prevent relapse and Change into epilepsy.Methods: 181 children patients were selected for this survey fro m children’s hospital of chongqing medical university from April 2013 to October 2017,that met the inclusion criteria and used three dr ugs(VPA,LEV,TPM)to prevent CSF from recurrence.Following up the efficacy,adverse reaction and the change of EEG.Follow-up of0.5-5 years was carried out through neuropsychiatric outpatient revie w and telephone contact.The SPSS version 20.0 was used for data analysis and processing.The measurement data were expressed by mean value x(x±s).Counting data were checked by X2 and Fisher.T he difference of P<0.05 was statistically significant.Results:1.group VPA: 86 cases(81.1%).had no recurrence in 106 case s.There were 63 cases with normal initial EEG,52 cases without re currence(82.5%).There were 43 cases with abnormal initial EEG,34 cases without recurrence(79.1%),and no statistically difference in the two groups(X2=0.201,P=0.654,> 0.05).2.group LEV: 28 cases(62.2%)had no recurrence in 45 cases.There were 32 cases with normal initial EEG,21 cases without rec urrence(65.6%).There were 13 cases with abnormal initial EEG,7cases without recurrence(53.8%),and no statistically difference in th e two groups(X2=0.160,P=0.690,>0.05).3.group TPM: 20 cases(66.7%)had no recurrence in 30 cases.There were 18 cases with normal initial EEG,13 cases without rec urrence(72.2%).There were 12 cases with abnormal initial EEG,7cases without recurrence(58.3%),and no statistically difference in th e two groups(X2=0.625,P=0.461,>0.05).4.In the 181 subjects,there were 113 cases with normal EEG,86 cases(76.1%)without recurrence,68 cases with abnormal EEG,48 cases without recurrence(70.6%),and no statistically difference in the two groups(X2=0.672,P=0.412,> 0.05).5.181 cases were included in the analysis to use three drugs,134 cases without recurrence(74.0%),statistically difference(X2=6.891,P=0.032,<0.05)among the three groups.Pairwise comparisions: stati stically significant(X2=6.106,P=0.013,<0.05)between the VPA and LEV,It indicates that the efficiency of VPA in preventing CFS child ren’s recurrence is higher than group LEV.No statistically significant(X2=2.846,P=0.092,>0.05)between the VPA and TPM.No statisti cally significant(X2=0.154,P=0.694,>0.05)between the LEV and TPM.It indicates that VPA and TPM,TPM and LEV are similar in preventing the recurrence of children with CFS.6.Adverse reaction: 4 cases(3.8%)in group VPA,3 cases(6.7%)in LEV group,6 cases(20.0%)in group TPM,After the corr esponding treatment has been improved.Statistically difference(X2=9.259,P=0.01,<0.05)among the three groups.Pairwise comparisions:No statistically significant(X2=0.123,P=0.726,> 0.05)between the V PA and LEV.Statistically significant(X2=6.812,P=0.009,<0.05)bet ween the VPA and TPM.Statistically significant(X2=4.266,P=0.039,<0.05)between the LEV and TPM.The results showed that the adv erse reaction rate of VPA,LEV and TPM in preventing CFS recurre nce was low and mild.Although the adverse reaction rate of TPM was relatively high,the compliance of the children was still better.7.The recovery of EEG after medication: in group VPA,first:there were 43 cases of abnormal EEG before treatment,35 cases(81.4%)recovered after medication;second: 13 cases of abnormal EEG i n group LEV,10 cases(76.9%)recovered after medication;third: 12 cases of abnormal EEG in group TPM,10 cases(83.3%)recovered af ter medication.There was no significant difference(X2=0.186,P=0.911,>0.05)between the three groups,and the overall improvement rate was 80%.The results showed that VPA,LEV and TPM had better effects in improving the abnormal EEG in children with CSF.Conclusion:1.VPA,LEV and TPM have good efficacy to prevent CSF fro m recurrence.The overall effect is higher and the probability of epil epsy is reduced.It showed that all of them have a good effect on p reventing the recurrence of CFS and transforming into epilepsy.2.Among the three drugs of VPA,TPM and LEV,VPA has the best effect on preventing CFS recurrence,and the compliance of chi ldren is higher,which is worth popularizing as the first choice drug.3.The clinical adverse effects of VPA,TPM and LEV are lowe r,but the adverse reaction rate and the severity of TPM are still hig her than those of VPA and LEV.4.VPA,TPM and LEV have similar effects on improving the a bnormal EEG in children with CFS.5.Abnormal and normal EEG before medication is no great clinical value in predicting prognosis and recurrence. |
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