左乙拉西坦联合丙戊酸钠对成人癫痫患者脑电图、骨代谢和骨密度指标的影响  

Effect of levetiracetam and sodium valproate on electroencephalogram,bone metabolism,and bone mineraldensity in adult patients with epilepsy

作　　者：陈妍[1] 梁玉婵[1] 黄振华 李又佳[1] 黄燕[1] CHEN Yan;LIANG Yu-chan;HUANG Zhen-hua;LI You-jia;HUANG Yan(Department of Neurology,Zhaoqing First People's Hospital,Zhaoqing 526000,Guangdong,CHINA)

机构地区：[1]肇庆市第一人民医院神经内科,广东肇庆526000

出　　处：《海南医学》2022年第2期162-165,共4页Hainan Medical Journal

摘　　要：目的探讨左乙拉西坦联合丙戊酸钠对成人癫痫患者脑电图、骨代谢、骨密度指标的影响。方法回顾性分析2018年4月至2020年8月肇庆市第一人民医院神经内科收治的80例成人癫痫患者的临床资料,其中40例采用左乙拉西坦片联合丙戊酸钠治疗者纳入观察组,40例给予丙戊酸钠单药治疗者纳入对照组。比较两组患者的临床疗效以及治疗前后的脑电图、骨代谢、骨密度水平。结果观察组患者的治疗总有效率为95.00%,明显高于对照组的75.00%,差异有统计学意义(P>0.05);两组患者治疗后的棘波均少于治疗前,且观察组治疗后棘波为(13.09±1.85)次/min,明显少于对照组的(18.92±2.41)次/min,差异均有统计学意义(P<0.05);两组患者治疗前后的血磷、血钙比较差异均无统计学意义(P>0.05);观察组患者治疗前后的碱性磷酸酶比较差异无统计学意义(P>0.05),但对照组患者治疗后的碱性磷酸酶较治疗前明显上升,且对照组治疗后的碱性磷酸酶为(79.37±13.06)U/L,明显高于观察组的(72.24±11.21)U/L,差异均有统计学意义(P<0.05);观察组患者治疗前后的腰椎、股骨颈及股骨大转子骨密度比较差异均无统计学意义(P>0.05),但对照组患者治疗后的腰椎、股骨颈及股骨大转子骨密度明显低于治疗前,差异均有统计学意义(P<0.05),而观察组治疗后的腰椎、股骨颈及股骨大转子骨密度分别为(0.73±0.14)g/cm^(3)、(0.75±0.19)g/cm^(3)、(0.64±0.14)g/cm^(3),明显高于对照组的(0.65±0.10)g/cm^(3)、(0.67±0.14)g/cm^(3)、(0.58±0.10)g/cm^(3),差异均有统计学意义(P<0.05)。结论左乙拉西坦联合丙戊酸钠治疗成人癫痫可提高治疗效果,减少脑电图棘波,且对患者骨代谢、骨密度指标影响小,可在临床上推广应用。Objective To investigate the effects of levetiracetam combined with sodium valproate on electroen-cephalogram(EEG),bone metabolism,and bone mineral density in adult patients with epilepsy.Methods The clinical data of 80 adult patients with epilepsy in the Department of Neurology,Zhaoqing First People's Hospital from April 2018 to August 2020 were analyzed retrospectively.Forty patients who were treated with levetiracetam tablets combined with sodium valproate who met the sodium-exhaust standard were selected as the observation group,with propensity matching 1:1,and 40 patients who were given sodium valproate monotherapy were selected as the control group.The clinical efficacy,the levels of EEG,bone metabolism,and bone mineral density before and after treatment were compared.Results The effective rate of treatment in the observation group was 95.00%,which was significantly higher than 75.00%in the control group(P>0.05).Spike waves after treatment in the two groups were less than those before treatment,and the spike waves after treatment was(13.09±1.85)times/min in the observation group,significantly less than(18.92±2.41)times/min in the control group(P<0.05).There was no significant difference in blood phosphorus and blood calcium between the two groups after treatment and before treatment(P>0.05).There was no statistically significant difference in alkaline phosphatase before and after treatment in the observation group(P>0.05);after treatment,the alkaline phosphatase in the control group was significantly higher than that before treatment,(79.37±13.06)U/L vs(72.24±11.21)U/L,P<0.05.The bone mineral density of the lumbar spine,femoral neck,and greater trochanter of the observation group after treatment was not statistically different from those before treatment(P>0.05);the bone mineral density of the lumbar spine,femoral neck,and greater trochanter after treatment in the control group were significantly lower than those before treatment(P<0.05);after treatment,the bone mineral density of the lumbar spine,femor

关 键 词：成人癫痫 左乙拉西坦 丙戊酸钠 脑电图 骨代谢 骨密度 

分 类 号：R742.1[医药卫生—神经病学与精神病学]