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目的对照观察苯巴比妥(PB)和银杏叶对单纯性惊厥(SFC)患儿血清神经元特异性烯醇化酶(NSE)的不同影响。方法将符合纳入标准的188例SFC患儿随机分为3组。惊厥未用药组:不使用PB及其他止惊药;PB止惊组:予PB(10 mg.kg-1,但每次不超过150 mg)肌肉注射,每天1次,连用2 d;PB+银杏叶组:在PB止惊组基础上当日予银杏叶,≤2岁每次15 mg、>2岁每次20 mg,每天2次,连用14 d。健康对照组为同期体检抽血的健康儿童。各组SFC患儿分别在惊厥发作后2 d、7 d及21 d时取静脉血2 mL,ELISA法测定血清NSE水平。结果 1.>2岁组:各SFC组在惊厥发作后2 d时NSE水平均较健康对照组明显增高(Pa<0.01)。7 d时NSE水平均有回落,但仍较健康对照组高(Pa<0.05,0.01)。2.≤2岁组:PB止惊组在2 d、7 d和21 d时NSE均高于惊厥未用药组(Pa<0.01)。而PB+银杏叶组在各时点NSE水平的增高与惊厥未用药组比较差异无统计学意义。惊厥未用药组NSE水平在2 d、7 d、21 d各时点呈逐渐下降过程。而PB组在各时点的NSE水平递降却不明显。PB+银杏叶组NSE水平自7 d起至21 d时明显递减。结论 SFC发作引起儿童血清NSE水平一过性轻度增高,提示惊厥性脑损伤的存在;PB会进一步加重SFC患儿血清NSE水平的增高,银杏叶则有降低血清NSE水平和减轻PB脑损伤的可能性。
Objective To observe the different effects of phenobarbital (PB) and Ginkgo biloba on serum neuron-specific enolase (NSE) in children with simple convulsion (SFC). Methods A total of 188 children with SFC who met the inclusion criteria were randomly divided into three groups. Convulsions were not used group: do not use PB and other arrestants; PB only group: PB (10 mg.kg-1, but not more than 150 mg) intramuscularly, once daily for 2 d; PB + Leaf group: on the basis of PB group only on the day of Ginkgo biloba, ≤ 2 years old each 15 mg,> 2 years old each 20 mg, 2 times a day, once every 14 d. Healthy control group for the same period of physical examination blood of healthy children. In each group, 2 mL venous blood was collected at 2 d, 7 d and 21 d after seizure onset, and serum NSE level was measured by ELISA. Results> In the> 2-year-old group, the levels of NSE in each SFC group were significantly higher than those in healthy control group (P <0.01) at 2 days after seizure onset. The level of NSE decreased on the 7th day, but still higher than that of the healthy control group (Pa <0.05,0.01). 2.≤2-year-old group: The NSE of PB-shock group at 2 d, 7 d and 21 d were higher than that of the uncontrolled convulsion group (Pa0.01). However, the level of NSE in PB + Ginkgo biloba group was not significantly different from that in non-drug group. The levels of NSE in convulsions non-medication group decreased gradually at 2 d, 7 d and 21 d. However, the decline of NSE level in PB group was not obvious at all time points. NSE levels in PB + Ginkgo biloba group decreased significantly from day 7 to day 21. CONCLUSIONS: Seizure-induced NSE levels in children with SFC have a mild and transient increase, suggesting the existence of convulsive brain injury. PB may further aggravate the serum levels of NSE in children with SFC. Ginkgo biloba has the effect of decreasing serum NSE levels and alleviating PB injury possibility.