Background Epilepsy is a chronic episodic brain disorder with a high incidence and can seriously affect the quality of life of the patients. Therefore,timely treatment to control seizures is particularly important. Numerous studies have shown the effect of antiepileptic drugs on cognition,but there are few studies on the effects of different functional areas in children. Objective To explore the effects of sodium valproate（VPA）,oxcarbazepine（OXC）and levetiracetam（LEV）on the development of different functional areas in children with focal epilepsy by Griffiths Development Scales-Chinese Edition（GDS-C）. Methods A total of 83 children with focal epilepsy who attended in outpatient and ward of the Department of Pediatric Neurology of the Third Affiliated Hospital of Zhengzhou University for the first time from January 2021 to April 2022were selected,and randomly divided into VPA group（n=27）,OXC group（n=28） and LEV group（n=28） according to the random number table method,30 healthy children who were examined during the same period were selected as the control group.The changes of EEG interictal epileptiform activity（IEA）before and after 6 months of treatment were recorded and the clinical effect was evaluated according to seizure frequency,the GDS-C was used to evaluate the development quotient of each functional area in the children. Results The total clinical effective rates of VPA group,OXC group and LEV group were 92.6%,89.3%and 92.9%,with no significant difference among the three groups（χ2=0.418,P=1.000）. The total EEG IEA effective rate of the VPA group,OXC group and LEV group were 88.9%,57.1% and 89.3%,with significant differences among the three groups（χ2=11.152,P=0.004）;the total effective rate of EEG IEA in OXC group was lower than that in VPA group and LEV group（P＜0.05）. Before treatment,there were statistically significant differences in the the development quotient of each dimension among four groups（P＜0.05）;the development quotient of each dimension in three groups were lower than that in the control group（P＜0.05）. After treatment,there were significant differences in the the development quotients of hand-eye coordination and performance dimensions among three groups（P＜0.05）;the development quotients of sports and personal-social dimensions in LEV group were higher than VPA group（P＜0.05）,the development quotients of personal-social,hand-eye coordination and performance dimensions in LEV group were higher than OXC group（P＜0.05）. Compared to the pre-treatment period,the development quotients of personal-social and practical reasoning dimensions significantly decreased in VPA group（P＜0.05）,the development quotients of personal-social,language,hand-eye coordination,performance and practical reasoning dimensions significantly increased（P＜0.05）. Conclusion VPA,OXC and LEV are all effective in the treatment of focal epilepsy in children,and all three have quivalent efficacy;In terms of improving EEG IEA,OXC is inferior to VPA and LEV;VPA may have a negative effect on personal-social and practical reasoning dimensions,OXC has little effect,and LEV may have improvement on personal-social,language,hand-eye coordination,performance,practical reasoning dimensions.

目的 探讨脑脊液中纤维连接蛋白(FN)、血管内皮生长因子(VEGF)及乳酸脱氢酶(LDH)水平在鉴别诊断儿童细菌性脑膜炎(BM)和病毒性脑炎(VE)中的价值.方法 选取31例BM患儿(BM组)、34例VE患儿(VE组)及26例非中枢神经系统(CNS)感染患儿(对照组)为研究对象.采用酶联免疫吸附法(ELISA)检测3组患儿治疗前后脑脊液中FN、VEGF、LDH水平;采用受试者工作特征(ROC)曲线分析FN、VEGF及LDH对BM、VE的鉴别诊断价值,采用Pearson系数分析三者的相关性.结果 治疗前,BM组FN、VEGF、LDH水平均高于对照组及VE组,VE组FN水平低于对照组,差异有统计学意义(P＜0.05).治疗后,BM组FN、VEGF、LDH水平降低,VE组FN、LDH水平均降低,差异有统计学意义(P＜0.05).FN、VEGF及LDH鉴别诊断BM组与VE组、BM组和对照组的ROC曲线下面积(AUC)均＞0.9,FN鉴别诊断VE组和对照组的AUC＞ 0.8,但VEGF及LDH鉴别诊断VE组和对照组的AUC ＜0.6.BM组中FN、VEGF及LDH之间两两呈正相关,VE组中VEGF与LDH呈正相关,而对照组中FN、VEGF及LDH之间无相关性.结论 检测脑脊液中FN、VEGF、LDH水平对BM、VE和非CNS感染的鉴别诊断具有一定临床价值.