新型抗癫痫药物联合CPAP治疗癫痫合并阻塞性睡眠呼吸暂停综合征的疗效观察

Efficacy observation of new antiepileptic drugs combined with CPAP in the treatment of epilepsy complicated with obstructive sleep apnea syndrome

目的探讨新型抗癫痫药物联合经鼻持续气道正压通气(CPAP)治疗癫痫合并阻塞性睡眠呼吸暂停综合征的临床疗效。方法 60例癫痫合并阻塞性睡眠呼吸暂停综合征患者,按能否耐受CPAP治疗分为对照组(32例,不耐受CPAP治疗)和治疗组(28例,耐受CPAP治疗)。治疗组接受新型抗癫痫药物(左乙拉西坦、拉莫三嗪)联合CPAP治疗,对照组接受传统型抗癫痫药物(丙戊酸钠、卡马西平)治疗。观察比较两组治疗前后癫痫发作次数、呼吸暂停低通气指数和呼吸暂停低通气总时间及治疗后脑电图改善情况。结果两组治疗前癫痫发作次数、呼吸暂停低通气指数及呼吸暂停低通气总时间比较,差异无统计学意义(P>0.05);两组治疗后癫痫发作次数、呼吸暂停低通气指数及呼吸暂停低通气总时间比较,差异具有统计学意义(P<0.05)。治疗组患者总有效率为85.71%,显著高于对照组的40.63%,差异具有统计学意义(P<0.05)。结论 CPAP联合左乙拉西坦与拉莫三嗪治疗癫痫合并阻塞性睡眠呼吸暂停综合征患者时,能够明显减少患者癫痫发作次数,改善睡眠状态。

Objective To investigate the clinical efficacy of new antiepileptic drugs combined with transnasal continuous positive airway pressure （CPAP） ventilation in the treatment of epilepsy complicated with obstructive sleep apnea syndrome. Methods A total of 60 epilepsy patients complicated with obstructive sleep apnea syndrome were divided into control group fol 32 cases （Patients didn＇t tolerate CPAP therapy） and treatment group for 28 cases （patients tolerated CPAP therapy） according to whether CPAP could be tolerated. The treatment group received new antiepileptic drugs （Levetiracetam, Lamotrigine） combined with CPAP therapy, the control group received traditional antiepileptic drugs （Sodium Valproate, Carbamazepine） therapy. The epileptic seizures frequency, apnea-hypopnea index, total apnea-hypopnea time before and after treatment, the improvement of EEG after treatment were observed and compared between the two groups. Results There were no significant differences in the number of epileptic seizures, apnea-hypopnea index and total apnea-hypopnea time between the two groups before treatment （P〉0.05）. There were significant differences in the number of epileptic seizures, apnea-hypopnea index and total apnea-hypopnea time between the two groups after treatment （P〈0.05）. The total effective rate of the treatment group was 85.71%, which was significantly higher than 40.63% of the control group, the difference was statistically significant （P〈0.05）. Conclusion CPAP combined with Levetiracetam and Lamotrigine in the treatment of epilepsy patients complicated with obstructive sleep apnea syndrome can significantly reduce the number of epileptic seizures and improve sleep status.