拉莫三嗪治疗新诊断成人部分性癫痫患者的疗效及其对脑电活动的影响

Curative effect of lamotrigine on newly diagnosed partial epilepsy and its impact on brain electrial activity

目的探讨拉莫三嗪(LTG)对新诊断成人部分性癫痫患者的临床疗效及其对脑电活动的影响。方法选择LTG单药治疗山东省临沂市人民医院新诊断的65例成人部分性癫痫患者,并进行开放性自身对照随访研究,观察LTG治疗2、6、12个月的总有效率及对脑电图波形的影响。以治疗前8周基线期平均每月癫痫发作频率为标准,与给予LTG治疗后随访每月癫痫发作频率比较,作为疗效评价标准。两样本间脑电背景活动参数(α波、θ波、δ波)比较采用t检验,多样本比较采用Ridit分析。结果 LTG治疗癫痫患者2个月时无发作37例(56.9%),显效11例(16.9%),有效10例(15.4%),无效7例(10.8%),总有效率89.2%;LTG治疗2、6、12个月时疗效比较差异无统计学意义(F=0.67,P>0.05)。治疗6个月时间歇期痫样放电(IEA)消失或减少50%以上者27例(41.5%),治疗12个月时IEA消失或减少50%以上者29例(44.6%)。治疗前患者α波的均值为(10.02±0.12)Hz,LTG治疗6个月时,α波的平均值为(9.89±0.11)Hz,治疗前后差异无统计学意义(t=1.619,P>0.05)。脑电背景30 s内θ波数治疗前为(9.41±0.28)个,治疗后为(11.77±0.38),差异有统计学意义(t=4.657,P<0.05);δ波治疗前为(3.11±0.16)个,治疗后为(3.29±1.42)个,差异无统计学意义(t=1.809,P>0.05)。结论 LTG单药治疗新诊断成人部分性癫痫患者有较好的疗效,且使痫样放电减少或消失,对脑电背景活动影响较小,对脑电图的改善效果值得肯定。

Objective To investigate the curative effect of Lamtrigine （LTG） in patients who were new diagnosed partial epilepsy and its impact on brain electrical activity. Methods A self-controlled, open- lable study was carried out among sixty-five adults with newly diagnosed partial epilepsy receiving LTG monotherapy. The total effective rate and impact on electroencephalogram waveform among the subjects were observed after 2, 6 and 12 months of therapy. The comparison of seizure frequency a month before and after LTG treatment was the standard to evaluate the curative effect. Results With LTG monotherapy, 2 months later there were 37 cases of non-seizures （56.9%）, 11 cases of significant efficacy （ 16.9% ）, 10 cases of normal efficacy （ 15.4% ）, 7 cases of no efficacy （ 10.8% ） and the whole efficacy was 89.2%. There was no statistical significance of comparison of efficacy whatever after 2, 6 or 12 months with LTG monotherapy （F = 0.67,P 〉 0.05 ）. After 6 months therapy, interical epileptiform abnormalities （IEA） decreased or eliminated more than 50% in 27 patients （41.5%） , and in 29 patients （44.6%） when 12 months later. The average number of α was （ 10.02 ＋ O. 12） Hz and （9.89 ±0.11 ） Hz before and 6 months after therapy, there was no statistical significance of average number of α （ t = 1. 619, P 〉 0.05 ）. In 30 seconds of brain electrical activity, the number of θ was （9.41 ±0.28 ） and （ 11.77± 0.38） before and after treatment, there was statistical significance （ t = 4.657, P 〈 0.05 ）. The number of was （ 3.11 ± 0.16 ） and （ 3.29 ± 1.42 ） before and after treatment, there was no statistical significance （ t = 1. 809, P 〉 0.05 ）. Conclusions LTG has a better curative effect and few influence on brain electrical activity in patients who were new diagnosed partial epilepsy, With the help of LTG therapy, IEA decreases or eliminateshas, electroencephalogram has been promoted at the same time.