奥卡西平联合托吡酯对脑卒中后癫痫患者认知恢复的影响  

The effect of oxcarbazepine combined with topiramate on cognitive recovery in patients with epilepsyafter stroke

作　　者：李友俊[1] 夏鹰[1] 林鹏[1] 韩奖励[1] 李晓波[1] LI Youjun;XIA Ying;LIN Peng;HAN Jiangli;LI Xiaobo(Department of Neurosurgery, Haikou People's Hospital, Haikou 570208, China)

机构地区：[1]海口市人民医院神经外科,海南海口570208

出　　处：《西部医学》2020年第11期1669-1672,共4页Medical Journal of West China

基　　金：海南省海口市科学技术局科研项目(201811543)。

摘　　要：目的研究奥卡西平联合托吡酯对脑卒中后癫痫患者认知恢复的影响。方法选取2017年6月~2018年6月在我院接受治疗的脑卒中后癫痫患者80例,按照完全随机法分为联合组和对照组,每组各40例。联合组患者使用奥卡西平联合托吡酯进行治疗,对照组患者使用托吡酯进行治疗。检测两组患者治疗前后胰岛素样生长因子1(IGF-1)、神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白β(S100β)、癫痫放电及累及导联数;进行简易智力状态评分(MMSE)、蒙特利尔认知评分(MOCA)、日常生活能力评分(ADL),统计治疗效果及不良反应发生率。结果治疗后联合组患者IGF-1水平高于对照组,NSE、S100β水平低于对照组(P<0.05);治疗后联合组MMSE评分、MOCA评分、ADL评分均高于对照组(P<0.05);治疗后联合组患者癫痫放电及累及导联数低于对照组(P<0.05);联合组患者治疗总有效率高于对照组(P<0.05)。结论奥卡西平联合托吡酯治疗脑卒中后癫痫可促进患者认知功能恢复,减少患者癫痫发作次数,提高患者日常生活能力及生活质量,效果显著。Objective To study the effect of oxcarbazepine combined with topiramate on cognitive recovery in patients with epilepsy after stroke.Methods 80 patients with post-stroke epilepsy treated in our hospital from June 2017 to June 2018 were divided into combined treatment group and control group according to complete random method,40 cases in each group.Patients in the combined treatment group were treated with oxcarbazepine and topiramate,while patients in the control group were treated with topiramate.Insulin-like growth factor-1(IGF-1),post neuron specific enolase(NSE),central nerve specific proteinβ(S100β),epileptic discharge and the number of involved leads were measured before and after the treatment in the two groups.MMSE,MOCA and ADL were performed.The therapeutic effect and the incidence of adverse reactions were counted.Results After treatment,the levels of IGF-1 in the combined treatment group were higher than those in the control group,while the levels of NSE and S100βwere lower than those in the control group(P<0.05).The scores of MMSE,MOCA and ADL in the combined treatment group were higher than those in the control group(P<0.05).The leads of epileptic discharge and involvement in the combined treatment group were lower than those in the control group after treatment.(P<0.05).After treatment,the total effective rate of the combined treatment group was higher than that of the control group(P<0.05).Conclusion Oxcarbazepine combined with topiramate in the treatment of post-stroke epilepsy can promote the recovery of cognitive function,reduce the number of epileptic seizures,and improve the daily living ability and quality of life of patients with significant effect.

关 键 词：奥卡西平 托吡酯 脑卒中 癫痫 累及导联数 

分 类 号：R742.1[医药卫生—神经病学与精神病学]