丙戊酸钠联合艾地苯醌对癫痫患者治疗效果的研究

Study of therapeutic effect of idebenone combined with sodium valproate

目的探讨丙戊酸钠联合艾地苯醌对癫痫患者睡眠状况及血清胰岛素样生长因子1(IGF-1)、Bcl-2蛋白(Bcl-2)、神经元特异性烯醇化酶(NSE)水平的影响。方法选取2016年3月至2018年3月山西博爱医院神经内科收治的81例癫痫患者,采用随机数表法将其随机分为单药治疗组和联合治疗组,单药治疗组42例,男27例,女15例,年龄(31.12±5.08)岁,年龄范围为23~75岁;联合治疗组39例,男23例,女16例,年龄(30.28±5.43)岁,年龄范围为22~75岁。单药治疗组采用丙戊酸钠治疗,联合治疗组采用丙戊酸钠联合艾地苯醌治疗。观察两组患者治疗效果、癫痫改善情况(发作次数、持续时间、癫痫积分)、痫样放电、累及导联数、呼吸紊乱指数(AHI)、最低血氧饱和度(LSO2)、平均血氧饱和度(MSO2)、血清IGF-1、Bcl-2、NSE水平。结果治疗后,联合治疗组总有效率[92.3%(36/39)]显著高于单药治疗组[66.7%(28/42)];发作次数、持续时间、癫痫积分[(0.39±0.12)次、(1.98±0.41)min、(0.97±0.20)分]均低于单药治疗组[(1.76±0.51)次、(2.84±0.53)min、(2.63±0.52)分];痫样放电、累及导联数[(6.39±1.32)次/180 s、(3.46±0.58)]均低于单药治疗组[(11.51±2.30)次/180 s、(5.97±0.96)];血清NSE水平[(34.40±4.97)μg/L]低于单药治疗组[(42.09±6.67)μg/L]、血清IGF-1、Bcl-2水平[(147.08±43.32)μg/L、(36.45±4.18)pg/ml]高于单药治疗组[(118.49±40.72)μg/L、(30.82±3.53)pg/ml];AHI水平(22.47±6.35)低于单药治疗组(36.86±9.63),LSO2、MSO2水平[(80.73±21.24)%、(89.75±9.75)%]均高于单药治疗组[(70.07±16.32)%、(83.23±7.42)%],差异均有统计学意义(P<0.05)。结论丙戊酸钠联合艾地苯醌对癫痫患者治疗效果显著,可有效改善患者的睡眠状况、发作次数及持续时间,可调节神经元细胞表达,提高患者的生活质量。

Objective To investigate the effects of sodium valproate combined with idebenone on sleep status, serum insulin-like growth factor 1(IGF-1), bcl-2 protein(Bcl-2)and neuron-specific enolase(NSE)levels in epileptic patients. Methods A retrospective study was performed on 81 cases of epileptic who were admitted from March 2016 to March 2018.Patients were randomly divided into the monotherapy and combined treatment.There were 42 patients in the monotherapy group, including 27 males and 15 females, aged(31.12±5.08)years and ranging from 23 to 75 years.There were 39 cases in the combined treatment group, including 23 males and 16 females, aged(30.28±5.43)years, ranging from 22 to 75 years old.The monotherapy group was treated with sodium valproate, while the combination therapy group was treated with sodium valproate combined with idebenone.The therapeutic effect, improvement of epilepsy(number of seizures, duration, epilepsy score), epileptic discharge, number of involved leads, AHI, LSO2, MSO2, serum igf-1, Bcl-2, and NSE levels were observed in the two groups. Results After treatment, the total effective rate of the combined treatment group [92.3%(36/39)] was significantly higher than that of the monotherapy group [66.7%(28/42)]. The number of seizures, duration, and seizure scores [(0.39±0.12)times,(1.98±0.41)min and(0.97±0.20)scores] were all lower than those in the monotherapy group [(1.76±0.51)times,(2.84±0.53)min and(2.63±0.52)scores]. The amount of epileptic discharge and the number of involved leads [(6.39±1.32)times/180 s,(3.46±0.58)] were lower than those in the monotherapy group [(11.51±2.30)times/180 s,(5.97±0.96)]. Serum NSE levels [(34.40±4.97)g/L] were lower than those in the monotherapy group [(42.09±6.67)g/L], serum igf-1 and Bcl-2 levels [(147.08±43.32)μg/L,(36.45 ± 4.18)pg/ml], and were higher than those in the monotherapy group [(118.49±40.72)μg/L,(30.82±3.53)pg/ml]. AHI level(22.47±6.35)was lower than that of monotherapy group(36.86±9.63), LSO2 and MSO2 levels [(80.73±21.24)%,(89.75±9.75)%] were lower than that of monotherapy group [(70.07±16.32)%,(83.23±7.42)%], and the differences were statistically significant(P<0.05). Conclusion Valproate sodium combined with idebenone has a significant therapeutic effect on epilepsy patients, which can effectively improve the sleep status, attack frequency and duration of patients, regulate the expression of neuronal cells, and improve the quality of life of patients.