左乙拉西坦分别联合奥卡西平与丙戊酸钠治疗局灶性癫痫的效果比较  

Comparison of the effects of levetiracetam combined with oxcarbazepine and sodium valproate respectively on focal epilepsy

作　　者：羡一心[1] 刘凯[1] 王帆[1] Xian Yixin;Liu Kai;Wang Fan(Department of Neurology,Zhengzhou University Affiliated Children's Hospital/Henan Provincial Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院神经内科,450000

出　　处：《临床医学》2024年第9期80-83,共4页Clinical Medicine

摘　　要：目的比较左乙拉西坦联合奥卡西平与左乙拉西坦联合丙戊酸钠治疗局灶性癫痫的效果。方法选择郑州大学附属儿童医院2021年1月至2022年12月收治的局灶性癫痫患儿52例为研究对象,根据家长意愿分为A组与B组,每组26例。A组接受左乙拉西坦联合奥卡西平治疗,B组接受左乙拉西坦联合丙戊酸钠治疗。比较两组疗效、认知功能[简明精神状态检查量表(MMSE)评分]、血清指标[同型半胱氨酸(Hcy)、超敏C反应蛋白(hs⁃CRP)、非对称性二甲基精氨酸(ADMA)]。结果两组治疗总有效率比较,差异未见统计学意义(P>0.05)。A组治疗2、4、6个月后MMSE评分均高于B组(P<0.05)。两组治疗6个月后Hcy、hs⁃CRP、ADMA水平均高于组内治疗前(P<0.05),两组间治疗6个月后比较,差异未见统计学意义(P>0.05)。结论左乙拉西坦联合奥卡西平或联合丙戊酸钠治疗局灶性癫痫疗效均可,但均可引起血清指标升高,均有心血管不良事件发生风险,且奥卡西平对认知功能的改善作用更好。Objective To compare the effects of levetiracetam combined with oxcarbazepine and levetiracetam combined with sodium valproate on focal epilepsy.Methods Fifty⁃two focal epilepsy patients admitted to Zhengzhou University Affiliated Children's Hospital from January 2021 to December 2022 were selected as the research subjects,and were divided into group A and group B by parental will,with 26 cases in each group.Group A was treated with levetiracetam combined with oxcarbazepine,and group B was treated with levetiracetam combined with sodium valproate.The therapeutic effect,cognitive function[minimum mental state examination(MMSE)score],serum indexes[homocystine(Hcy),hypersensitive C⁃reactive protein(hs⁃CRP),asymmetric dimethylarginine(ADMA)]were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups(P>0.05).MMSE scores in group A were higher than those in group B after 2,4 and 6 months of treatment(P<0.05).After 6 months of treatment,the levels of Hcy,hs⁃CRP and ADMA in the two groups were higher than those before treatment(P<0.05),and there was no significant difference between the two groups after 6 months of treatment(P>0.05).Conclusions Levetiracetam combined with oxcarbamazepine or combined with sodium valproate is effective on focal epilepsy,but both could cause elevated serum indexes,so both are at risk for adverse cardiovascular events,and oxcarbamazepine had a better effect on improving cognitive function.

关 键 词：局灶性癫痫 左乙拉西坦 奥卡西平 丙戊酸钠 

分 类 号：R742.1[医药卫生—神经病学与精神病学]