观察左乙拉西坦+丙戊酸钠治疗癫痫的效果  

Observation on effect of levetiracetam+sodium valproate in the treatment of epilepsy

作　　者：曹续政 谷久梅 乔东海 CAO Xu-zheng;GU Jiu-mei;QIAO Dong-hai(Joint Logistics Support Force 962nd Hospital,Harbin 150080,China)

机构地区：[1]联勤保障部队第962医院,150080

出　　处：《中国实用医药》2025年第4期124-127,共4页China Practical Medicine

摘　　要：目的观察左乙拉西坦联合丙戊酸钠治疗方案在癫痫治疗中的效果。方法选取癫痫患者100例,随机分为对照组(50例)与观察组(50例)。对照组给予丙戊酸钠治疗,观察组给予丙戊酸钠+左乙拉西坦治疗。比较两组认知功能,疾病发作情况,血清神经递质[神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、脑源性神经营养因子(BDNF)]水平,不良反应发生情况。结果治疗后,观察组言语能力、定向力、即刻记忆力、注意力和计算力、回忆能力评分分别为(7.92±0.59)、(8.63±0.23)、(2.73±0.04)、(4.18±0.13)、(2.58±0.08)分,高于对照组的(6.36±0.76)、(7.35±0.46)、(2.28±0.05)、(3.41±0.19)、(2.05±0.07)分(P<0.05)。治疗后,观察组发作次数(0.73±0.11)次/年、脑电图棘波变化(13.25±1.38)次/min明显较对照组的(1.44±0.33)次/年、(18.47±2.25)次/min少,发作持续时间(2.35±0.53)min/次明显较对照组的(3.58±0.26)min/次短(P<0.05)。治疗后,观察组NSE(31.53±5.32)μg/L、GFAP(1.48±0.47)ng/ml低于对照组的(43.79±6.68)μg/L、(1.86±0.53)ng/ml,BDNF(39.57±5.28)pg/ml高于对照组的(32.79±4.82)pg/ml(P<0.05)。观察组不良反应发生率低于对照组,但比较差异不明显(P>0.05)。结论在癫痫治疗中应用左乙拉西坦+丙戊酸钠用药方案,能够有效控制患者病情,预后效果较好。Objective To observe the effect of levetiracetam combined with sodium valproate in the treatment of epilepsy.Methods 100 patients with epilepsy were randomly divided into a control group(50 cases)and an observation group(50 cases).The control group was treated with sodium valproate,and the observation group was treated with sodium valproate+levetiracetam.respectively.Comparison of cognitive function,disease onset,serum levels of neurotransmitters[neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP),brain-derived neurotrophic factor(BDNF)]and occurrence of adverse reactions between the two groups.Results After treatment,the scores of verbal ability,orientation,immediate memory,attention and calculation,and recall ability in the observation group were(7.92±0.59),(8.63±0.23),(2.73±0.04),(4.18±0.13),and(2.58±0.08)points,which were higher than(6.36±0.76),(7.35±0.46),(2.28±0.05),(3.41±0.19),and(2.05±0.07)points in the control group(P<0.05).After treatment,the number of seizures and electroencephalogram spike changes in the observation group were(0.73±0.11)times/year and(13.25±1.38)times/min,which were significantly less than(1.44±0.33)times/year and(18.47±2.25)times/min in the control group;the observation group had significantly shorter duration of seizure of(2.35±0.53)min/time than(3.58±0.26)min/time in the control group(P<0.05).After treatment,the observation group had NSE of(31.53±5.32)μg/L and GFAP of(1.48±0.47)ng/ml,which were lower than(43.79±6.68)μg/L and(1.86±0.53)ng/ml in the control group;the observation group had higher BDNF of(39.57±5.28)pg/ml than(32.79±4.82)pg/ml in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not significant(P>0.05).Conclusion The combination of levetiracetam and sodium valproate in the treatment of epilepsy can effectively control the patient's condition and have a good prognosis.

关 键 词：左乙拉西坦 丙戊酸钠 癫痫 神经递质 不良反应 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]