左乙拉西坦联合恩必普对脑卒中后癫痫认知功能的影响

Clinical analysis of Butylphthalide and levetiracetam for cognitive function in post-stroke epilepsy patients

目的观察左乙拉西坦片联合恩必普对脑卒中后癫痫患者认知功能的影响。方法选取河南大学第一附属医院2015年3月—2016年9月收治的100例脑卒中后癫痫患者,随机分为联合用药组(n=50)和对照组(n=50),联合用药组给予左乙拉西坦片联合恩必普治疗,对照组给予左乙拉西坦治疗,治疗随访1年,治疗前、治疗后1年两组均采用视频脑电图、简易精神状况检查量表及P300检测对认知功能进行评分。同时观察两组临床治疗效果、认知功能改善及不良反应发生情况。结果联合治疗组治疗有效率89.8%,较对照组80%更高(P<0.05);联合治疗组认知功能改善明显优于对照组(P<0.05),两组治疗后SPM测验情况均较治疗前显著改善(P<0.05);联合用药组治疗后P300波潜伏期及波幅改善情况显著优于对照组,两组比较差异有统计学意义(P<0.05)。两组不良反应较轻微,均可耐受。结论脑卒中后癫痫患者,左乙拉西坦联合恩必普能显著改善脑卒中后癫痫患者癫痫发生以及认知水平,不良反应少,安全性高,值得临床推广应用。

Objective To observe the effects of Butylphthalide and Levetiracetam on cognitive function in post-stroke epilepsy. Methods Patients with post-stroke epilepsy were randomly divided into the drug combination group(50 cases） and the control group(50 cases）. The Drug combination group was given Butylphthalide and Levetiracetam,and the control group was given Levetiracetam,Follow-up for all patients was 1 year,and the therapeutic efficacy was measured with video electroencephalogram,mini-mental state examination and data analysis of event-related potential P300 was conducted before and after treatment. Results Therapeutic efficacy of the drug combination group was significantly better than those of the control group,there was statistical significance between two groups(P〈0. 05）; there was significant difference between two groups by MMSE(P〈0. 05）; there was statistical significance in P300 latencies and amplitudes in two groups after treatment(P〈0. 05）. The ADR of two groups were not serious. Conclusion Butylphthalide combinating with Levetiracetam can improve cognitive function for patients with post-stroke epilepsy with good safety.