左乙拉西坦联合鼠神经生长因子治疗难治性癫痫临床疗效及对患者血清Bcl-2 Fas FasL水平的影响  

The clinical efficacy of levetiracetam combined with mouse nerve growth factor in the treatment of refractory epilepsy and its effect on the serum levels of Bcl-2,Fas,FasL in patients

作　　者：张洪波[1] 陈冬霞[1] 冯青芝[1] 邢世珠 郝娜娜[1] Zhang Hongbo;Chen Dongxia;Feng Qingzhi;Xing Shizhu;Hao Nana(Sanmenxia Central Hospital,Sanmenxia 472000,Henan,China)

机构地区：[1]三门峡市中心医院,河南三门峡472000

出　　处：《临床心身疾病杂志》2021年第4期11-15,34,共6页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨左乙拉西坦联合鼠神经生长因子治疗难治性癫痫的疗效及对患者血清FasL、Fas、Bcl-2水平的影响。方法将63例难治性癫痫患者按随机数字表法分为研究组(32例)和对照组(31例)。对照组予以左乙拉西坦治疗,研究组在对照组基础上联合鼠神经生长因子治疗,治疗6个月。统计两组临床疗效及不良反应发生率,比较治疗前及治疗3个月、6个月末癫痫发作情况、神经细胞因子(脑源性神经营养因子、胰岛素样生长因子-1、髓鞘碱性蛋白、S100β)、单胺类神经递质(去甲肾上腺素、5-羟色胺、多巴胺)、细胞凋亡相关蛋白(FasL、Fas、Bcl-2)水平。结果研究组总有效率显著高于对照组(P<0.05)。治疗3个月、6个月末研究组癫痫发作频率显著低于对照组(P<0.01),发作持续时间显著短于对照组(P<0.01),血清脑源性神经营养因子、胰岛素样生长因子-1、去甲肾上腺素、5-羟色胺、多巴胺水平显著高于对照组(P<0.01),血清髓鞘碱性蛋白、S100β、FasL、Fas、Bcl-2水平显著低于对照组(P<0.01)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论左乙拉西坦联合鼠神经生长因子治疗难治性癫痫可有效调控细胞凋亡相关蛋白、神经细胞因子及单胺类神经递质水平,控制癫痫发作,提高临床疗效,且未增加不良反应发生风险。Objective To explore the clinical efficacy of levetiracetam combined with mouse nerve growth factor in the treatment of refractory epilepsy and its effect on the serum levels of Bcl-2,Fas,FasL in patients.Methods A total of 63 patients with refractory epilepsy were divided into a study group(32 cases)and a control group(31 cases)according to the random number table method.The control group was treated with levetiracetam,and the study group was treated with mouse nerve growth factor on the basis of the control group for 6 months.The clinical efficacy and incidence of adverse reactions of the two groups were statistically analyzed.Epileptic seizures,levels of nerve cytokines[brain-derived neurotrophic factor(BDNF),insulin-like growth factor-1(IGF-1),myelin basic protein(MBP),S100β],monoamine neurotransmitters[norepinephrine(NE),5-hydroxytryptamine(5-HT),dopamine(DA)]and apoptosis related proteins(FasL,Fas,Bcl-2)were compared before treatment,3 months and 6 months after treatment.Results The total effective rate of the study group was significantly higher than that of the control group(P<0.05).After 3 months and 6 months of treatment,the frequency of seizures in the study group was significantly lower than that in the control group,and the duration of seizures was significantly shorter than that in the control group(P<0.05).The serum BDNF,IGF-1,NE,5-HT and DA levels were significantly higher than those of the control group(P<0.01),and serum MBP,S100β,FasL,Fas and Bcl-2 levels were significantly lower than those of the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Levetiracetam combined with mouse nerve growth factor in the treatment of refractory epilepsy can effectively regulate the levels of apoptosis-related proteins,nerve cytokines and monoamine neurotransmitters,control seizures,and improve clinical efficacy without increasing the risk of adverse reactions.

关 键 词：难治性癫痫 鼠神经生长因子 左乙拉西坦 FASL FAS BCL-2 

分 类 号：R742.1[医药卫生—神经病学与精神病学]