摘要
目的探讨脑卒中后癫痫应用丙戊酸钠与乙拉西坦联合治疗的临床疗效。方法86例脑卒中后癫痫患者,按随机数字表法分为对照组和观察组各43例,对照组给予常规神经内科脑卒中治疗及丙戊酸钠治疗,观察组在此基础上给予乙拉西坦治疗,观察两组临床疗效,对比两组治疗前后癫痫发作情况、癫痫发作时昏迷程度、认知功能、日常生活能力和血清相关蛋白水平变化,评估用药安全性。结果观察组总有效率高于对照组(P<0.05);治疗后,两组癫痫发作次数减少,发作持续时间缩短,格拉斯哥昏迷评分法(GCS)评分、蒙特利尔认知评估量表(MoCA)评分及改良Bathel量表(MBI)评分提高,血清脑源性神经营养因子(BDNF)水平升高,血清神经元特异性烯醇化酶(NSE)水平降低(P<0.05),观察组以上指标改善均优于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论丙戊酸钠联合乙拉西坦治疗脑卒中后癫痫患者疗效确切,可有效改善癫痫发作程度和发作时昏迷状况,提高患者认知功能和日常生活能力,利于患者神经系统损伤修复和疾病归转,临床药物不良反应少。
Objective To investigate the clinical efficacy of sodium valproate combined with etiracetam in the treatment of post stroke epilepsy.Methods Eighty six patients with post stroke epilepsy were randomly assigned to control or observation groups,43 in each group.The control group was given sodium valproate,and the observation group was given etiracetam on the basis of the control group.The clinical efficacy of the two groups was observed.The epilepsy seizures,coma degree during epilepsy seizures,cognitive function,daily living ability and serum related proteins levels were compared between the two groups before treatment and after 1 year of treatment.The medication safety was also assessed in the two groups.Results The total clinical effective rate in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the frequency of epilepsy seizures was significantly decreased,the duration of seizures was significantly shortened,the Glasgow Coma Scale(GCS)score,Montreal Cognitive Assessment Scale(MoCA)score and modified Bathel scale(MBI)score were significantly improved in the two groups(P<0.05).The level of serum brain derived neurotrophic factor(BDNF)was significantly increased(P<0.05)while the level of serum neuron specific enolase(NSE)was significantly decreased(P<0.05).The changes of the above indicators in the observation group were significantly greater than those in the control group(P<0.05).The incidence rates of adverse reactions in the observation group was less than that in the control group(P>0.05).Conclusion Sodium valproate combined with etiracetam has obvious efficacy in the treatment of patients with post stroke epilepsy.The therapy can effectively improve the seizure degree and coma during the onset,enhance the cognitive function and daily living ability,and facilitate the repair of nervous system damage and disease outcomes.It has few drug adverse reactions in clinical practice.
作者
贾丽娟
陈鹏
鱼丽萍
王沛
JIA Li juan;CHEN Peng;YU Li ping;WANG Pei(Department of Neurology,Xianyang First People s Hospital,Shanxi 712000,China)
出处
《实用医院临床杂志》
2019年第6期8-11,共4页
Practical Journal of Clinical Medicine
基金
陕西省重点研发计划项目(编号:2017SF-243)
