左乙拉西坦联合卡马西平对难治性癫痫持续状态和认知功能及脑电图变化的影响  

Effect of levetiracetam combined with carbamazepine on cognitive function and electroencephalogram changes in patients with intractable epilepsy

作　　者：甘露[1] 甘本辉 江剑辉[1] GAN Lu;GAN Benhui;JIANG Jianhui(Department of Neurology,Fengcheng People's Hospital,Yichun,Jiangxi,331100,China)

机构地区：[1]丰城市人民医院神经内科,江西宜春331100

出　　处：《当代医学》2024年第20期83-87,共5页Contemporary Medicine

摘　　要：目的探讨左乙拉西坦联合卡马西平对难治性癫痫持续状态和认知功能及脑电图变化的影响。方法选取2020年6月至2022年6月丰城市人民医院收治的82例难治性癫痫患者作为研究对象,随机分为对照组与观察组,各41例。对照组给予卡马西平治疗,观察组给予左乙拉西坦联合卡马西平治疗,比较两组临床疗效、癫痫发作频次、蒙特利尔认知评估量表(Montreal cognitive assessment,MOCA)评分、脑电图变化、血清炎症因子[WBC、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)]、血清神经细胞因子[胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)]及不良反应发生情况。结果观察组治疗总有效率为90.24%,高于对照组的68.29%,差异有统计学意义(P<0.05)。治疗后,两组癫痫发作频次均少于治疗前,MOCA评分高于治疗前,且观察组癫痫发作频次少于对照组,MOCA评分高于对照组,差异有统计学意义(P<0.05)。治疗后,两组脑电图变化优于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。治疗后,两组WBC、CRP、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清IGF-1水平均高于治疗前,NSE水平均低于治疗前,且观察组血清IGF-1水平高于对照组,NSE水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论左乙拉西坦联合卡马西平治疗难治性癫痫的疗效显著,可减少癫痫发作频次,改善认知功能和脑电图,调节炎症及神经细胞因子分泌,且安全性较高。Objective To investigate the effect of levetiracetam combined with carbamazepine on cognitive function and electroencephalogram changes in patients with intractable epilepsy.Methods 82 patients with intractable epilepsy who were admitted to Fengcheng People's Hospital from June 2020 to June 2022 were selected as the study subjects,and they were randomly divided into the control group and the observation group,with 41 cases in each group.The former was treated with carbamazepine,while the latter was treated with levetiracetam combined with carbamazepine,the clinical efficacy,epileptic seizure frequency,Montreal cognitive assessment(MOCA)score,electroencephalogram changes,serum inflammatory factors(WBC,C-reactive protein[CRP]and interleukin-6[IL-6]),serum neurocytokines(insulin-like growth factor-1[IGF-1]and neuron-specific enolase[NSE])and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 90.24%,which was higher than 68.29%in the control group,and the difference was statistically significant(P<0.05).After treatment,the frequency of epileptic seizures of the two groups was less than that before treatment,and the MOCA score was higher than that before treatment,and the frequency of epileptic seizures in the observation group was less than that in the control group,and the MOCA score was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the changes of electroencephalogram of the two groups were better than those before treatment,and the observation group was better than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of WBC,CRP and IL-6 of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of serum IGF-1 of the two groups were higher than those before treatment,the levels of NSE were lowe

关 键 词：难治性癫痫 左乙拉西坦 卡马西平 持续状态 认知功能 脑电图 炎症因子 

分 类 号：R74[医药卫生—神经病学与精神病学]