左乙拉西坦治疗难治性癫痫效果及其对细胞免疫水平的影响  

Clinical results and changes in cellular immunity of patients with intractable epilepsy in treatment with levetiracetam

作　　者：吴瑞[1] 李海军[1] 王柳毅[1] 王乐[1] 刘胜武[1] WU Rui LI Haijun WANG Liuyi WANG Le LIU Shengwu.(Department of Neurology, Affiliated Hospital of Yan＇an University, Yan＇ an 716000,China)

机构地区：[1]延安大学附属医院神经内科二病区,716000

出　　处：《疑难病杂志》2017年第5期465-468,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察左乙拉西坦治疗难治性癫痫效果及其对细胞免疫水平的影响。方法将2013年2月—2015年2月延安大学附属医院神经内科二病区收治难治性癫痫患者84例,随机数字表法分为观察组和对照组各42例。对照组予卡马西平片,初始剂量5 mg·kg^(-1)·d^(-1),以后每周增加10 mg·kg^(-1)·d^(-1),直至增至20 mg·kg^(-1)·d^(-1);托吡酯片初始剂量0.5 mg·kg^(-1)·d^(-1),以后每周增加2 mg·kg^(-1)·d^(-1),逐步增至8 mg·kg^(-1)·d^(-1)。观察组应用左乙拉西坦,初始剂量10 mg·kg^(-1)·d^(-1),2次/d,每隔1周增加10 mg·kg^(-1)·d^(-1),4周后增至35 mg·kg^(-1)·d^(-1)并维持治疗。2组患者均连续治疗6个月。比较2组患者临床效果,治疗前后癫痫发作次数、CD3^+、CD4^+、CD8^+、DR^+水平变化情况,并记录不良反应发生情况。结果治疗后观察组总有效率95.2%显著高于对照组81.0%(x^2=4.086,P=0.044);治疗后,观察组癫痫发作次数、CDg^+、DR^+明显低于对照组,CD3^+、CD4^+、IgA、IgG、IgM显著高于对照组(t=3.021、8.793、7.761、3.924、5.962、1.845、4.427、2.113,P<0.05,P<0.01);2组患者未发生药物中毒,治疗过程中发生恶心、头晕、嗜睡、食欲减退、记忆力减退、白细胞降低、皮疹、情绪异常等不良反应,减缓加量速度后缓解,2组各不良反应发生情况比较,差异无统计学意义(P>0.05)。结论左乙拉西坦治疗难治性癫痫患者疗效确切,减少发作次数,有效改善细胞免疫水平,安全可靠,值得临床推广应用。Objective To observe the effect of levetiracetam on refractory epilepsy and its effect on cellular immunity.Methods Eighty-four cases of patients with intractable epilepsy were selected,who were treated in hospital from February2013 to February 2015,and they were divided into the study group（42 cases） and control group（42 cases）.The patients of control group were treated with carbamazepine tablets（initial dose of 5 mg·kg-1 · d-1,increase of 10 mg · kg-1·d-1 per week until increased to 20 mg · kg-1· d-1） and topiramate tablets（initial dose of 0.5 mg·kg-1· d-1,followed by weekly increase of 2 mg · kg-1· d-1,and gradually increased to 8 mg · kg-1· d-1）,and on the basis of the control group,the patients of study group were treated with levetiracetam（initial dose 10 mg · kg-1· d-1,2 times/d,increased 10 mg · kg-1·d-1 in every 2 weeks,until to 35 mg · kg-1· d-1 and maintenance treatment）.The patients of two groups were all treated for6 months.Compare the clinical effect,adverse reactions and changes of the levels of seizures,CD3＋,CD4＋,CD8＋,DR＋of two groups were compared.Results After the appropriate treatment,the patients of the study group got a total effective rate of 95.2%,which was significandy better than the 81.0%of the control group（x2=4.086,P =0.044）;the levels of seizures,CD8＋,DR＋ of the study group were significandy lower than those of the control group（t = 3.021,t =8.793,t =7.761,P =0.002,P =0.000,P =0.000）;The levels of CD3＋,CD4＋,IgA,IgG,IgM of the study group were significandy higher than those of the control group（t=3.924,t =5.962,t =1.845,1 =4.427,t=2.113,P =0.000,P =0.000,P =0.034,P =0.000,P =0.018）;there were nausea,dizziness,drowsiness,loss of appetite,memory loss,leukopenia,rash,mood disorders and other adverse reactions occurred in both two groups,but there were no statistically significant between the two groups（x2=0.473,x2=0.829,x2=0.956,x2=2.429,x2=0.000,x2=0.473,x2=1.664,x2=0.378;P=0.492,P=0.362,P=0.328,P=0.119,P=0.492,P=0.197,P

关 键 词：难治性癫痫 左乙拉西坦 细胞免疫水平 临床效果 

分 类 号：R742.1[医药卫生—神经病学与精神病学]