Efficacy of midazolam in the Treatment of Acute Convulsions in Children and Its Effects on Convulsive Brain Tissue Injury

IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY
Jing Zhang, Jing Dong, Ling Jiang, Lin Ge, Ran Dong
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引用次数: 0

Abstract

This study focused on addressing the efficacy of midazolam in the treatment of acute convulsions in children and its effects on convulsive brain tissue injury.

A total of 124 children with acute convulsions were separated into the control group and the observation group according to the random number table method. Children in the control group received intravenous injection therapy with diazepam (0.3–0.5 mg/kg); those in the observation group received midazolam buccal mucosa administration treatment (different doses for different age groups). The total effective rate of treatment and adverse reactions were observed. The number of children whose convulsions were controlled within 1, 3, and 5 minutes after medication, the time to initial convulsion control, the number of children who experienced recurrence within 10 minutes after control, and the time to recurrence control were recorded. Juvenile (21-day-old) Sprague-Dawley rats were separated into blank control, model, low-dose midazolam, medium-dose midazolam, and high-dose midazolam groups. Rats in the midazolam groups were injected intraperitoneally with different doses of midazolam. The convulsive model rats were prepared by intraperitoneal injection of pentylenetetrazol, and the emergence time and duration time of convulsions were recorded. The convulsion grade of rats was evaluated. The rats were euthanized, and their brain tissues were taken. The pathological morphological changes in the brain tissues were observed, and glial fibrillary acidic protein (GFAP) and gamma-aminobutyric acid (GABA) expression levels in the brain tissues were tested.

The observation group demonstrated a higher total effective treatment rate, a greater number of children whose convulsions were controlled within 3 and 5 minutes of treatment, a shorter average time to convulsion control, a lower recurrence rate within 10 minutes after initial control, a shorter time to control recurrent convulsions, and a lower incidence of adverse reactions compared to the control group. Convulsive model rats that received medium- and high-dose midazolam displayed prolonged emergence time of convulsions, shorter duration, and lower convulsion grade. In convulsive model rats, the nucleus of hippocampal neurons was deeply stained and showed pyknosis; the arrangement of neurons was disordered; the cells were loose and edematous. In the convulsive model, rats received medium- and high-dose midazolam, and the neuron pyknosis and cell oedema were alleviated. In the hippocampus of convulsive model, rats received high-dose midazolam, GFAP expression levels were reduced, and GABA expression levels were raised (p < 0.05).

For children with acute convulsions, midazolam buccal mucosa administration can rapidly control convulsive seizures and reduce recurrence rates with high safety. High-dose midazolam can ameliorate brain tissue injury in convulsed rats, reduce GFAP expression levels in hippocampal tissue, and increase GABA expression levels.

咪达唑仑治疗儿童急性惊厥的疗效及对惊厥性脑组织损伤的影响
本研究主要探讨咪达唑仑治疗儿童急性惊厥的疗效及其对惊厥性脑组织损伤的影响。将124例急性惊厥患儿按随机数字表法分为对照组和观察组。对照组患儿静脉注射地西泮(0.3 ~ 0.5 mg/kg)治疗;观察组患者给予咪达唑仑颊黏膜给药治疗(不同年龄组不同剂量)。观察两组总有效率及不良反应。记录给药后1分钟、3分钟、5分钟惊厥得到控制的患儿人数、开始控制惊厥的时间、控制后10分钟出现复发的患儿人数、控制复发的时间。将幼年(21日龄)Sprague-Dawley大鼠分为空白对照组、模型组、低剂量、中剂量、高剂量咪达唑仑组。咪达唑仑各组大鼠分别腹腔注射不同剂量的咪达唑仑。采用腹腔注射戊四唑制备惊厥模型大鼠,记录惊厥出现时间和持续时间。评价大鼠惊厥程度。这些老鼠被安乐死,并取走了它们的脑组织。观察大鼠脑组织病理形态学变化,检测脑组织胶质原纤维酸性蛋白(GFAP)和γ -氨基丁酸(GABA)表达水平。观察组患儿总有效治愈率较高,治疗后3、5分钟惊厥得到控制的患儿较多,痉挛控制平均时间较短,初始对照后10分钟复发率较低,反复惊厥控制时间较短,不良反应发生率较对照组低。中、高剂量咪达唑仑惊厥模型大鼠惊厥出现时间延长,持续时间缩短,惊厥等级降低。惊厥模型大鼠海马神经元核深度染色,呈固缩;神经元排列紊乱;细胞疏松水肿。在惊厥模型中,大鼠给予中、高剂量咪达唑仑后,神经元固缩和细胞水肿均有所减轻。在惊厥模型大鼠海马中,大剂量咪达唑仑使GFAP表达水平降低,GABA表达水平升高(p <;0.05)。对于急性惊厥患儿,咪达唑仑颊粘膜给药可迅速控制惊厥发作,降低复发率,安全性高。大剂量咪达唑仑可改善惊厥大鼠脑组织损伤,降低海马组织GFAP表达水平,增加GABA表达水平。
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来源期刊
Developmental Neurobiology
Developmental Neurobiology 生物-发育生物学
CiteScore
6.50
自引率
0.00%
发文量
45
审稿时长
4-8 weeks
期刊介绍: Developmental Neurobiology (previously the Journal of Neurobiology ) publishes original research articles on development, regeneration, repair and plasticity of the nervous system and on the ontogeny of behavior. High quality contributions in these areas are solicited, with an emphasis on experimental as opposed to purely descriptive work. The Journal also will consider manuscripts reporting novel approaches and techniques for the study of the development of the nervous system as well as occasional special issues on topics of significant current interest. We welcome suggestions on possible topics from our readers.
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