不同頻率低頻重復(fù)經(jīng)顱磁刺激對癲癇兒童骨代謝、脂代謝及生活質(zhì)量的影響

　　[摘要] 目的 觀察不同頻率低頻重復(fù)經(jīng)顱磁刺激（rTMS）對癲癇兒童骨代謝、脂代謝及生活質(zhì)量的影響。 方法 選取2014年3月～2017年3月保定市第一中心醫(yī)院收治的156例癲癇患兒，采用簡單隨機(jī)抽樣法分為對照組（50例）、0.5 Hz組（53例）和1.0 Hz組（53例）。在原抗癲癇治療方案基礎(chǔ)上，對照組給予假刺激治療，0.5Hz組給予0.5Hz的rTMS治療，1.0 Hz給予1.0 Hz的rTMS治療，三組均持續(xù)治療3個(gè)月；比較三組治療前后癲癇發(fā)作頻率及頭痛發(fā)生情況、骨代謝指標(biāo)[鈣（Ca）、磷（P）、堿性磷酸酶（ALP）]、脂代謝指標(biāo)[總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）]及兒童生活質(zhì)量普適量表4.0（PedsQL4.0）評分變化。 結(jié)果 治療后，三組癲癇發(fā)作頻率均少于治療前（P < 0.05），且1.0Hz組癲癇發(fā)作頻率少于對照組和0.5Hz組（P < 0.05）； 三組治療期間頭痛發(fā)生率比較，差異無統(tǒng)計(jì)學(xué)意義（P > 0.05）；三組患兒Ca、P、ALP、TC、TG、LDL-C水平治療前后及治療后組間比較，差異無統(tǒng)計(jì)學(xué)意義（P > 0.05）；治療后，三組PedsQL4.0各維度評分均高于治療前（P < 0.05），且1.0 Hz組高于對照組和0.5 Hz組（P < 0.05）。 結(jié)論 1.0 Hz的rTMS可減少癲癇患兒癲癇發(fā)作頻率，改善患兒生活質(zhì)量，且短期對患兒骨代謝、脂代謝無明顯影響。
　　[關(guān)鍵詞] 經(jīng)顱磁刺激；癲癇；兒童；骨代謝；脂代謝；生活質(zhì)量
　　[中圖分類號] R748 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1673-7210（2018）02（c）-0106-04
　　Effects of low-frequency repetitive transcranial magnetic stimulation of different frequency on bone metabolism， lipid metabolism and quality of life of children with epilepsy
　　XU Bei1 WANG Guilan2
　　1.Department of General Pediatrics， the First Central Hospital of Baoding City， Hebei Province， Baoding 071000， China； 2.Department of Pediatrics， the First Hospital of Qinhuangdao City， Hebei Province， Qinhuangdao 066000， China
　　[Abstract] Objective To observe the effect of low-frequency repetitive transcranial magnetic stimulation （rTMS） of different frequency on bone metabolism， lipid metabolism and quality of life of children with epilepsy. Methods From March 2014 to March 2017， 156 children with epilepsy in the First Central Hospital of Baoding City were selected， and randomly divided into the control group （50 cases）， 0.5 Hz group （53 cases） and 1.0 Hz group （53 cases）. On the basis of the original antiepileptic treatment scheme， the control group was treated with sham stimulation， 0.5 Hz group was treated with rTMS of 0.5 Hz， and 1.0 Hz group was treated with rTMS of 1.0 Hz， all three groups were treated for 3 months. The seizure frequency of epilepsy and incidence of headache， bone metabolism indexes [calcium （Ca）， phosphorus （P）， alkaline phosphatase （ALP）]， lipid metabolism indexes [total cholesterol （TC）， triacylglycerol （TG）， low density lipoprotein cholesterol （LDL-C）]， and scores of the pediatric quality of life inventory measurement models （PedsQL4.0） before and after treatment in the three groups were compared. Results After treatment， the seizure frequency of epilepsy in the three groups was all lower than before treatment （P < 0.05）， and the seizure frequency of epilepsy in the 1.0 Hz group was lower than those in the control group and 0.5 Hz group （P < 0.05）， the incidence of headache in the three groups was compared， the difference was not statistically significant （P > 0.05）. In levels of Ca， P， ALP， TC， TG and LDL-C in the three groups before and after treatment and between groups after treatment were compared， the difference were not statistically significant （P > 0.05）. After treatment， The PedsQL4.0 each dimension score in three groups were higher than those before treatment （P < 0.05）， and the 1.0 Hz group was higher than those of the control group and 0.5 Hz group（P < 0.05）. Conclusion The rTMS of 1.0 Hz can reduce the seizure frequency of epilepsy and improve the quality of life of children. It has no obvious effect on lipid metabolism and bone metabolism in short term.

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