分析比较左乙拉西坦与卡马西平分别治疗难治性癫痫的临床效果和安全性

Clinical effects and safety of levetiracetam and carbamazepine in treatment of intractable epilepsy

目的分析左乙拉西坦与卡马西平治疗难治性癫痫的临床效果和安全性。方法选取2015年1月‐2017年1月该院收治的难治性癫痫患者76例,根据治疗方案的不同将其分为观察组和对照组,每组各38例。对照组使用卡马西平片治疗,观察组使用左乙拉西坦治疗。对比两组患者的临床效果和安全性。结果治疗后,观察组患者的治疗总效率为94.74%,明显高于对照组的78.95%,比较差异有统计学意义(P<0.05);两组癫痫发作次数明显下降,且观察组低于对照组,比较差异具有统计学意义(P<0.05);与治疗前比较,对照组细胞免疫水平无显著变化,比较差异无统计学意义(P>0.05);与对照组相比,观察组患者的分化簇3(CD3+)、分化簇4(CD4+)水平明显上升,分化簇8(CD8+)和抗组织相容性抗原-DR(HLA-DR)水平明显下降,比较差异有统计学意义(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论左乙拉西坦治疗难治性癫痫的临床效果要较卡马西平更显著,其可有效改善患者机体免疫能力,减少癫痫发作次数,且治疗安全性高。

【Objective】To analyze the clinical effects and safety of levetiracetam and carbamazepine in treatment of intractable epilepsy（IE）.【Methods】Seventy-six IE patients treated in our hospital from January 2015 to January 2017 were selected, and they were divided into observation group and control group by treatment regimens, 38 cases in each group. Control group was given carbamazepine, while observation group was given levetiracetam. The clinical effects and safety were compared between the two groups.【Results】After treatment, the total effective rate of observation group was 94.74%, which was higher than 78.95% of control group（P〈0.05）; the attack times of epilepsy in two groups significantly decreased, and observation group was lower than control group（P〈0.05）; compared with before treatment, the levels of cellular immunity in control group had no significant changes（P〉0.05）; compared with control group, the levels of CD3^＋ and CD4^＋ in observation group significantly increased, while the levels of CD8^＋ and human leucocyte antigen DR（HLA-DR） significantly decreased（P〈0.05）; the incidence of adverse reactions between the two groups had no statistical difference（P〉0.05）.【Conclusion】The clinical effect of levetiracetam in treatment of IE is more significant than that of carbamazepine, which can improve body immunity, reduce attack times of epilepsy and has higher safety.