摘要
目的探讨丙戊酸钠联合左乙拉西坦对老年脑卒中后癫痫患者的临床效果。方法选择2021年12月—2022年12月于泸州市人民医院诊治的老年脑卒中后癫痫患者104例,采用数字表法随机分为联合组和对照组,每组52例。对照组在接受常规治疗时应用丙戊酸钠治疗,联合组在与对照组相同治疗的基础上联合左乙拉西坦治疗,2组患者均治疗6个月。比较2组治疗前、治疗6个月后的癫痫控制情况、脑损伤及炎性指标[血清肿瘤坏死因子-α(TNF-α)、血清神经元特异性烯醇化酶(NSE)、血清星形胶质源性蛋白(S-100β)、血清高迁移率族蛋白B1(HMGB-1)]水平、认知功能评分[采用简易智能精神状态检查表(MMSE)评估]、神经心理学测验评分(采用神经心理测验量表评估)、治疗期间不良反应发生情况。结果治疗6个月后,联合组癫痫发作次数少于对照组,单次发作持续时间少于对照组(均P<0.05);2组血清TNF-α、NSE、S-100β及HMGB-1水平均低于同组治疗前,且联合组上述指标值低于对照组(均P<0.05);联合组MMSE总评分高于对照组(P<0.05);联合组数字广度、词语流畅性、数字符号转换分数均高于对照组,连线试验A、B型耗时均少于对照组(均P<0.05);联合组与对照组治疗不良反应发生率差异无统计学意义(13.46%vs 11.54%,P>0.05)。结论丙戊酸钠联合左乙拉西坦应用于老年脑卒中后癫痫患者,有利于降低癫痫发作频率,缩短发作持续时间,减轻脑组织损伤,改善认知功能,且安全性较好,具有一定的临床应用价值。
Objective To explore the clinical effects of sodium valproate combined with levetiracetam on elderly patients with epilepsy after stroke.Methods 104 elderly patients with post-stroke epilepsy treated in People's Hospital of Luzhou City from December 2021 to December 2022 were selected and randomly divided into control group and combined group,with 52 cases in each group.The control group received conventional treatment and sodium valproate treatment.The combined group was treated with levetiracetam on the same treatment as the control group.Both groups were treated for 6 months.Epilepsy control level,brain injury and inflammatory markers[serum tumor necrosis faction-α(TNF-α),serum neuron-specific enolase(NSE),serum astroglia-derived protein(S-100β),serum high mobility group protein B1(HMGB-1)],cognitive function[Mini Mental State Examination(MMSE)scores]and neuropsychological test(neuropsychological test scale)scores before treatment and after 6 months of treatment and the incidence of adverse reactions during treatment were compared between the two groups.Results After 6 months of treatment,the seizure frequency of epilepsy in the combined group was less than that in the control group,and the duration of single seizure was shorter than that in the control group(P<0.05);the levels of serum TNF-α,NSE,S-100βand HMGB-1 of both groups were lower than those of the same group before treatment,and the combined group was lower than the control group(P<0.05).After 6 months of treatment,the total MMSE score of the combined group was higher than that of the control group(P<0.05);the scores of digit span,verbal fluency and digital symbol conversion of the combined group were higher than those of the control group,and the time consumption of connection test type A and type B were shorter than those of the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group and the control group(13.46%vs 11.54%,P>0.05).Conclusion The application of sodium valproate
作者
唐青青
杨秋妹
胡慧
Tang Qingqing;Yang Qiumei;Hu Hui(Department of Geriatrics,People's Hospital of Luzhou City,Luzhou,Sichuan,646000,P.R.China)
出处
《老年医学与保健》
CAS
2024年第3期677-682,共6页
Geriatrics & Health Care
基金
四川省中医药管理科研项目(2024MS614)。
