左乙拉西坦治疗部分性癫痫发作121例的临床疗效及对脑电图的影响  

Clinical curative effect of levetiracetam on 121 diagnosed partial epilepsy patients and its impact on EEG

作　　者：侯蕴祈[1] 麦慧玲 石海琴[1] 黎泳欣[1] 钟剑平[1] 刘晓蓉[2] 

机构地区：[1]佛山市顺德第一人民医院神经内科,广东528300 [2]广州医科大学附属第二医院

出　　处：《脑与神经疾病杂志》2016年第3期177-181,共5页Journal of Brain and Nervous Diseases

摘　　要：目的探讨左乙拉西坦（LEV）治疗部分性癫痫患者的临床疗效及其对脑电图（EEG）的影响。方法选择LEV单药治疗的121例部分性癫痫患者,进行开放性自身对照随访研究,观察LEV治疗20w后的总有效率及对EEG波形的影响。以治疗前8w基线期平均每个月癫痫发作频率为标准,与给予LEV治疗后随访每个月癫痫发作频率比较,作为疗效评价标准,治疗前后疗效和脑电背景活动参数（α波、β波、θ波、δ波）比较采用χ~2检验,以P〈0.05为差异有统计学意义。结果 LEV治疗癫痫患者20w后无发作41例（33.9%）,显效39例（32.2%）,有效21例（17.4%）,无效15例（12.4%）,总有效率83.5%;不良反应发生率为18.3%,均为轻度皮疹,嗜睡,头晕,食欲下降等不良反应;治疗20w时间歇期痫样放电（IEA）消失或减少50%以上者84例（69.4%）。治疗前患者α波的均值为30±9Hz,治疗后,α波的平均值为29±8Hz,治疗前后差异无统计学意义（P〉0.05）。脑电背景30s内θ波数治疗前为23±7个,治疗后为33±8个,差异有统计学意义（P〈0.05）;β波治疗前均值为12.8±6.8Hz,治疗后均值为13.2±6.6Hz,治疗前后差异无统计学意义（P〉0.05）;δ波治疗前为17±6个,治疗后为16±8个,差异无统计学意义（P〉0.05）。结论 LEV治疗部分性癫痫患者有较好的疗效,副反应小,且使痫样放电减少或消失,对脑电背景活动影响较小,对EEG的改善效果明显。Objective To investigate the curative effect of levetiracetam（ LEV） in patients who were diagnosed partial epilepsy and its impact on brain electrical activity. Methods A self-controlled,openlable study was carried out among 121 patients with diagnosed partial epilepsy. The total effective rate and impact on electroencephalogram waveform among the subjects were observed after 20 weeks of therapy. The comparison of seizure frequency a month before and after LEV treatment was the standard to evaluate the curative effect. Results With LEV therapy,20 weeks later there were 41 cases of non-seizures（ 36. 9%）,significant efficacy was 83. 5%. There was statistical significance of comparison of efficacy after 20 weeks with LEV therapy（ P0.05）. The side effects rate was 18. 3%,including sleepiness,dizziness,excitement and loss of appetite. After 20 weeks therapy,interical epileptiform abnormalities（ IEA） decreased more than 50% in 84 patients（ 69.4%）. The average number of α was（ 30±9） Hz and（ 29±8） Hz before and 20 weeks after therapy,there was no statistical significance of average number of α（ P0.05）. In 30 seconds of brain electrical activity,the number of θ was（ 23±7） and（ 33±8） before and after treatment,there was statistical significance（ P〉0.05）. The number of β was（ 12.8±6.8） and（ 13.2±6.6） before and after treatment,there was no statistical significance（ P〉0.05）.The number of δ was（ 17±6） and（ 16±8） before and after treatment,there was no statistical significance（ P〉0.05）. Conclusion LEV has a better curative effect,few side effect and few influence on brain electrical activity in patients who were diagnosed partial epilepsy.

关 键 词：左乙拉西坦 部分性癫痫 脑电图 癫痫波 

分 类 号：R742.1[医药卫生—神经病学与精神病学]