脑卒中后迟发性癫痫的抗癫痫药物临床效果评价研究  

Clinical Efficacy Evaluation of Antiepileptic Drugs in the Treatment of Delayed Onset Epilepsy After Stroke

作　　者：翟志恒 汪中龙 杜冬青 田杨 ZHAI Zhiheng;WANG Zhonglong;DU Dongqing;TIAN Yang(Department of Neurology,Shandong Daizhuang Hospital,Jining Shandong 272051,China)

机构地区：[1]山东省戴庄医院神经内科,山东济宁272051

出　　处：《中国卫生标准管理》2025年第4期140-143,共4页China Health Standard Management

摘　　要：目的 探讨抗癫痫药物治疗脑卒中后迟发性癫痫的临床效果。方法 选择山东省戴庄医院2023年1月—2024年1月收治的120例脑卒中后迟发性癫痫患者,按随机数字表法分为研究组与对照组,各60例。研究组服用左乙拉西坦,对照组服用奥卡西平。服药前后比较2组癫痫发作次数、发作维持时长、累及导联数、痫样放电情况,并测评2组总有效率,测定2组白细胞介素-2(interleukin-2,IL-2)、白细胞介素-6(interleukin-6,IL-6)、烯醇化酶(neuron specific enolase,NSE)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),统计2组不良反应(恶心呕吐、嗜睡、皮疹、头晕)发生情况。结果 服药后,研究组癫痫发作次数、发作维持时长、累及导联数、痫样放电分别为(1.19±0.39)次/年、(3.02±0.98)min/次、(4.14±1.37)个/180 s及(9.22±2.37)次/180 s,低于对照组的(1.58±0.51)次/年、(3.87±1.25)min/次、(5.03±1.66)个/180 s及(10.57±2.92)次/180 s,差异有统计学意义(P <0.05)。研究组总有效率为86.67%,高于对照组的81.67%,但差异无统计学意义(P> 0.05)。研究组IL-2、IL-6、NSE及TNF-α分别为(47.39±4.12)μg/L、(24.67±3.20)μg/L、(33.95±4.24)μg/L及(31.48±4.50)μg/L,低于对照组的(58.33±5.06)μg/L、(30.55±4.17)μg/L、(40.68±5.30)μg/L及(40.96±5.02)μg/L,差异有统计学意义(P <0.001)。研究组不良反应总发生率为6.67%,低于对照组的21.67%,差异有统计学意义(P <0.05)。结论 2种药物的疗效相当,但左乙拉西坦能够有效减少癫痫发作次数,并缩短发作维持时间,同时减轻炎症反应,不良反应更少,安全性高。Objective To investigate the clinical effect of antiepileptic drugs in the treatment of delayed onset epilepsy after stroke.Methods A total of 120 patients with delayed onset epilepsy after stroke treated in Shandong Daizhuang Hospital from January 2023 to January 2024 were selected and divided into study group and control group according to random number table method,with 60 cases in each group. The study group received levetiracetam and the control group received oxcarbazepine. The number of seizures, duration of seizure maintenance, number of involved leads, and epileptic discharge were compared between the two groups before and after medication, and the total effective rate of the two groups was evaluated. Interleukin-2 (IL-2), interleukin-6 (IL-6), enolase (NSE), and tumor necrosis factor-α (TNF-α) were measured in both groups. Compare The incidence of adverse reactions (nausea, vomiting, drowsiness, rash, dizziness) in the two groups were analyzed. Results After taking the drug, the number of seizures, duration of seizure maintenance, number of involved leads, and epileptoid discharge in the study group were (1.19±0.39) times/year, (3.02±0.98) min/time, (4.14±1.37) /180 s and (9.22±2.37) times/180 s, respectively, which were lower than (1.58±0.51) times/year, (3.87±1.25) min/ time, (5.03±1.66) /180 s and (10.57±2.92) times/180 s in the control group, the differences were statistically significant (P < 0.05). The total effective rate of the study group was 86.67%, which was higher than 81.67% of the control group, but the difference was not statistically significant (P > 0.05). The levels of IL- 2, IL-6, NSE and TNF-α in the study group were (47.39±4.12) μg/L, (24.67±3.20) μg/L, (33.95±4.24) μg/L and (31.48±4.50) μg/L, respectively, which were lower than (58.33±5.06) μg/L, (30.55±4.17) μg/L, (40.68±5.30) μg/L and (40.96±5.02) μg/L in the control group, the differences were statistically significant (P < 0.001). The total incidence of adverse reactions in the study group was 6.67%,

关 键 词：迟发性癫痫 神经功能坏死 脑卒中 抗癫痫药物 奥卡西平 左乙拉西坦 

分 类 号：R741[医药卫生—神经病学与精神病学]