丙戊酸钠与拉莫三嗪联用对原发性癫痫患者外周血TNF-αIL-2的影响研究  

Effect of Valproate Combined with Lamotrigine on TNF-and IL-2 in Peripheral Blood of Patients with Primary Epilepsy

作　　者：庄俊鸿[1] 云天 王年臻 周治平[1] ZHUANG Junhong;YUN Tian;WANG Nianzhen(The People＇s Hospital ofHaikou,Hainan Haikou 570208,China)

机构地区：[1]海南省海口市人民医院神经内科,海南海口570208

出　　处：《河北医学》2018年第6期1007-1012,共6页Hebei Medicine

基　　金：海南省卫生和计划生育委员会普通医学资助项目;(编号:2014-14)

摘　　要：目的:研究探索疗效丙戊酸钠与拉莫三嗪复合使用对原发性癫痫患者外周血TNF、IL水平的影响和治疗的有效性及安全性。方法:本次观察病例为2013年3月至2017年3月就诊的确诊为原发性癫痫的患者150人,以就诊时间的前后编号,将参与研究的全部治疗患者随机分成对照组和观察组,每组75例,两组分别采用丙戊酸钠单独给药和丙戊酸钠联合拉莫三嗪给药,并进行随访。对比两组脑电图结果好转时间及异常放电例数比例、治疗后发作频次、SES评价分数、外周血TNF-α、IL-2水平及不良反应情况。结果:在疗效方面,观察组脑电图好转时间及异常放电比例方面结果显著低于对照组(P<0.05);观察组的3个月及6个月发作频次明显少于对照组(P<0.05);观察组的SES自尊评价平均分数显著高于对照组(P<0.05);联合用药的观察组在外周血TNF-α和IL-2水平明显比对照组低(P<0.05);并且在不良反应的发生率上观察组明显低于对照组,安全性更高。结论:丙戊酸钠与拉莫三嗪联合使用对癫痫治疗有着良好而稳定的疗效,在降低血TNF-α和IL-2水平的同时,其使用的安全性更高,不良反应发生率明显降低。此方法有效性与安全性较好,值得推广。Objective： To investigate the effect of combined use of sodium valproate and lamotrigine on peripheral blood levels of TNF and IL in patients with primary epilepsy and its efficacy and safety. Methods：The observation cases were 150 patients diagnosed as primary epilepsy in our hospital from March 2014 to March 2017. All the patients in the study were randomly divided into control group And observation group,with 75 cases in each group. The two groups were administered with valproate sodium alone and valproate combined with lamotrigine,and were followed up. The time of electroencephalogram（ EEG） improvement,the proportion of abnormal discharge,the frequency of postoperative seizure,the score of SES,the levels of TNF-α and IL-2 in peripheral blood and the adverse reactions were compared between the two groups. Results：In terms of curative effect,the results of EEG improvement time and abnormal discharge proportion in the observation group were significantly lower than those in the control group（ P〈0.05; the frequency of seizures in the observation group at 3 months and 6 months was significantly less than that in the control group（ P〈0.05=; The mean score of SES self-esteem in observation group was significantly higher than that in control group（ P〈0.05）; the level of TNF-α and IL-2 in peripheral blood of the combination group was significantly lower than that of the control group（ P〈0.05） The incidence of adverse reactions in the observation group was significantly lower than the control group,higher safety. Conclusion： Sodium valproate in combination with lamotrigine has a good and stable efficacy in the treatment of epilepsy,in reducing blood levels of TNF-α and IL-2 levels at the same time,the safety of its use is higher,the incidence of adverse reactions was significantly reduced.This method is effective and safe,it is worth promoting.

关 键 词：癫痫 丙戊酸钠 拉莫三嗪 TNF-Α IL-2 

分 类 号：R742.1[医药卫生—神经病学与精神病学]