奥卡西平联合左乙拉西坦治疗卒中后癫痫的效果研究  

Study on the Effect of Oxcarbazepine Combined With Levetiracetam in the Treatment of Post-Stroke Epilepsy

作　　者：林源 李卉[1] 韩国超[1] 何冬若[1] 多天骄 张天宇[1] LIN Yuan;LI Hui;HAN Guochao;HE Dongruo;DUO Tianjiao;ZHANG Tianyu(Department of Electrophysiology,the Second Affiliated Hospital of Qiqihar Medical University,Qiqihar Heilongjiang 161000,China)

机构地区：[1]齐齐哈尔医学院附属第二医院电生理科,黑龙江齐齐哈尔161000

出　　处：《中国卫生标准管理》2023年第8期147-151,共5页China Health Standard Management

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2020-KYYWF-0030)。

摘　　要：目的探讨奥卡西平联合左乙拉西坦治疗卒中后癫痫的长程脑电图特征。方法收集2019年1月—2020年1月于齐齐哈尔医学院附属第二医院神经内科诊疗的卒中2周后且至少有2次间隔≥24 h的癫痫发作的患者60例。按照随机数字表法分为对照组(n=31)和联合组(n=29)。其中对照组给予奥卡西平治疗,联合组给予奥卡西平联合左乙拉西坦治疗,治疗后分析联合用药对卒中后癫痫脑电图、癫痫的影响。结果治疗8个月后,两组患者的癫痫年发作次数和持续时间比较,联合组患者的癫痫年发作次数更短(P<0.05)。相较于对照组,联合组患者的癫痫发作持续时间显著缩短(P<0.05);两组痫样放电均显著降低,并且联合组显著低于对照组(P<0.05);两组累及导联数明显减少,联合组评分更高(P<0.05)。治疗总有效率比较,联合组(93.10%)高于对照组(67.74%)(P<0.05)。认知功能评分与治疗前比较,两组患者治疗后均显著提升,以联合组评分为著;联合组不良反应发生率(13.79%)高于对照组(9.68%),差异无统计学意义(P>0.05)。结论奥卡西平联合左乙拉西坦对于治疗卒中后癫痫发作患者效果良好,还可一定程度上改善患者的认知功能,且药物的不良反应较少。Objective To investigate the effect of oxcarbazepine combined with levetiracetam in the treatment of post-stroke epilepsy.Methods From January 2019 to January 2020,a total of 60 patients with at least two seizures with an interval 2 weeks after stroke≥24 hours were collected from the department of neurology of the Second Affiliated Hospital of Qiqihar Medical University.According to the method of random number table,they were divided into control group(n=31)and combined group(n=29).The patients in the control group were treated with oxcarbazepine,and the patients in the combined group were treated with oxcarbazepine and levetiracetam.The effects of oxcarbazepine and levetiracetam on EEG and seizures in patients with epilepsy after stroke were analyzed.Results After 8 months of treatment,the number and duration of epileptic seizures in the two groups were significantly shorter than those in the combined group(P<0.05).The duration of epileptic seizures in the combined group was significantly shorter than that in the control group(P<0.05).The epileptiform discharges in both groups were significantly reduced,and those in the combined group were significantly less than those in the control group(P<0.05).The number of involved leads in the two groups decreased significantly,and the number of involved leads in the combined group was significantly less than that in the control group(P<0.05).The total effective rate of the combined group(93.10%)was significantly higher than that of the control group(67.74%).The scores of cognitive function in both groups were significantly higher,and those in the combined group were significantly higher than those in the control group(P<0.05).The adverse reaction rate of the combined group(13.79%)was slightly higher than that of the control group(9.68%),but the difference was not statistically significant(P>0.05).Conclusion Oxcarbazepine combined with levetiracetam can improve the clinical efficacy and cognitive function of patients with post stroke epilepsy,and the adverse reactions of

关 键 词：脑卒中 奥卡西平 左乙拉西坦 癫痫 认知 神经 

分 类 号：R742[医药卫生—神经病学与精神病学]