Levetiracetam plus Oxcarbazepine Combination Treatment Downregulates Serum Multidrug Resistance Protein 1 Levels and Upregulates Neuropeptide Y Levels in Children with Epilepsy

Abstract The aim of the present study was to investigate the usefulness of multidrug resistance protein 1 (MDR1) and neuropeptide Y (NPY) levels in predicting the efficacy of levetiracetam (LEV) plus oxcarbazepine (OXC) treatment administered to children with epilepsy and to determine their prognosis. Overall, 193 children with epilepsy admitted to the hospital were enrolled and randomly divided into two groups according to different treatment methods: group A (n = 106, treated with LEV plus OXC combination) and group B (n = 87, treated with OXC only). After treatment, compared with group B, group A exhibited a remarkably higher total effective rate and a significantly lower total adverse reaction rate. Areas under the curve for MDR1 and NPY for predicting ineffective treatment were 0.867 and 0.834, whereas those for predicting epilepsy recurrence were 0.916 and 0.829, respectively. Electroencephalography abnormalities, intracranial hemorrhage, neonatal convulsion, premature delivery, and MDR1 and NPY levels were independent risk factors for poor prognosis in children with epilepsy. Serum MDR1 and NPY levels exhibited a high predictive value for early epilepsy diagnosis, treatment efficacy assessment, and prognostication in children with epilepsy treated with LEV plus OXC combination.

摘要 本研究旨在探讨多药耐药蛋白1（multidrug resistance protein 1, MDR1）与神经肽Y（neuropeptide Y, NPY）水平在预测癫痫患儿接受左乙拉西坦（levetiracetam, LEV）联合奥卡西平（oxcarbazepine, OXC）治疗疗效中的应用价值，并明确其对患儿预后的评估意义。本研究共纳入本院收治的193例癫痫患儿，按治疗方案不同随机分为两组：A组（n=106，接受LEV联合OXC治疗）与B组（n=87，仅接受OXC单药治疗）。治疗结束后，与B组相比，A组总有效率显著更高，总不良反应发生率显著更低。MDR1与NPY预测治疗无效的曲线下面积分别为0.867与0.834；二者预测癫痫复发的曲线下面积则分别为0.916与0.829。脑电图异常、颅内出血、新生儿惊厥、早产以及MDR1与NPY水平均为癫痫患儿预后不良的独立危险因素。血清MDR1与NPY水平对于接受LEV联合OXC治疗的癫痫患儿的早期诊断、疗效评估及预后判断均具有较高的预测价值。