传统抗癫痫药物用于中老年脑卒中后迟发性癫痫的比较研究

Comparative Study on Antiepileptic Drugs used by Middle-aged and Elderly Patients with Delayed Post-stroke Epilepsy

目的探讨传统抗癫痫药物在脑卒中后迟发性癫痫中老年患者中的不同特点和疗效。方法对我院2004年1月～2008年12月收治的270例中年(<65岁)和190例老年(≥65岁)脑卒中后迟发性癫痫患者的药物保留率进行了回顾性分析。结果中年组4种药物保留率依次为卡马西平(87.7%)>丙戊酸钠(75.8%)>苯妥英钠(53.7%)>氯硝西泮(41.2%);老年组4种药物保留率依次为丙戊酸钠(88.9%)>苯妥英钠(73.8%)>卡马西平(59.5%)>氯硝西泮(43.7%);中年组卡马西平疗效最好,控制率达66.7%,老年组丙戊酸钠疗效最好,控制率达72.1%。结论临床治疗脑卒中迟发性癫痫时,中、老年患者应分别首选卡巴西平和丙戊酸钠。

Objective To discuss the different characteristics and effects in middle-aged and elderly patients with Delayed post-stroke epilepsy.Methods 270 cases of middle-aged（65 years）and 190 cases of senile（≥ 65 years old）with delayed post-stroke epilepsy treated in our hospital from January 2004 to December 2008.And we retrospectively analyzed the drug retention rates in the patients.Results The 4 drugs retention rate of middle-aged group were carbamazepine（87.7%） sodium valproate（75.8%） phenytoin（53.7%） clonazepam（41.2%;4 drugs retention of old age group were sodium valproate（88.9%） phenytoin（73.8%） carbamazepine（59.5%） clonazepam（43.7%）;carbamazepine have the best efficacy in middle-aged group,the control rate of 66.7%;the best effect in old age group was sodium valproate,the control rate was 72.1%.Conclusion When delayed post-stroke epilepsy patients have the clinical treatment,the middle-aged patients shuoid select carbamazepine,while the eldly patients should choose sodium valproate.