奥卡西平联合维生素B12治疗高同型半胱氨酸老年癫痫患者的疗效观察

Effect of oxcarbazepine combined with vitamin B12 in the treatment of patients with high homocysteine in elderly epilepsy and the effects on Hcy and ICAM-1 levels

目的探讨奥卡西平联合维生素B12治疗高同型半胱氨酸老年癫痫患者的疗效及对Hcy、ICAM-1水平的影响。方法选取2016年6月~2017年7月在本院治疗的高同型半胱氨酸癫痫患者153例,根据给药方式不同分为对照组(76例)和观察组(77例),对照组给予奥卡西平单药治疗,观察组在对照组基础上联合应用维生素B12,观察两组患者治疗后疗效及血浆Hcy、ICAM-1表达水平变化,对两组患者认知功能进行评价并密切观察不良反应发生情况。结果对照组治疗后总有效率与观察组比较差异有统计学意义(P<0.05);两组患者血浆Hcy治疗后均有不同程度降低,观察组下降明显(P<0.05);两组患者血浆ICAM-1浓度治疗后均不同程度下降,观察组与对照组比较差异有统计学意义(P<0.05);两组患者治疗后认知功能评分均升高,观察组优于对照组(P<0.05);治疗期间,两组患者出现头晕、头痛、复视、共济失调、恶心、视力模糊等不良反应,其中对照组复视、共济失调、视力模糊发生率明显高于观察组,差异有统计学意义(P<0.05),而头晕、头痛、恶心发生率两组比较差异无统计学意义(P>0.05)。结论奥卡西平联合维生素B12治疗老年高同型半胱氨酸癫痫能明显提高治疗疗效,降低血清Hcy、ICAM-1浓度,提高患者认知功能,减少不良反应发生率。

Objective To study the effect of oxcarbazepine combined with vitamin B12 in the treatment of patients with high homocysteine in elderly epilepsy and the effects on Hcy and ICAM-1 levels. Methods From June 2016 to July 2017, 153 high homocysteine patients with epilepsy in our hospital, according to the different drugs, were divided into control group and observation group. The control group was given oxcarbazepine. The treatment group in the control group based on the combined application of vitamin B12. The plasma ICAM-1 and Hcy, the expression level changes, the cognitive function and the occurrence of adverse reactions were observed. Results After treatment, the total efficiency of observation group （89.61%） was higher than that of the control group （78.95%） （P〈0.05）. The plasma Hcy and ICAM-1 of observation group significantly decreased, compared with that of control group （P〈0.05）. The cognitive function score of observation group significantly increased, compared with that of control group （P〈0.05）. The side effect included dizziness, headache, diplopia, ataxia, nausea and blurred vision. The incidence of side effects of observation group was lower than that of the control. Conclusion Oxcarbazepine combined with vitamin B12 in treatment of elderly patients with hyperhomocysteinemia epilepsy can obviously enhance the curative effect, reduce serum Hey and ICAM-1 concentration, improve the cognitive function of patients and reduce the incidence of adverse reaction.