左乙拉西坦治疗成人癫痫疗效及对患者血清脑源性神经营养因子和miR-134-5p的影响

Efficacy of levetiracetam in treatment of adult epilepsy and its effect on serum BDNF and miR-134-5p

目的:观察左乙拉西坦对成人癫痫患者的治疗作用,分析其对患者血清中脑源性神经营养因子(BDNF)和微小RNA-134-5p(miR-134-5p)表达水平的影响。方法:选择126例癫痫患者,按入院顺序单双号分为观察组和对照组,各63例。观察组应用乙拉西坦进行治疗,对照组应用丙戊酸钠进行治疗,共治疗12个月。应用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估两组患者治疗后焦虑和抑郁评分并进行比较。应用酶联免疫吸附实验检测血清中BDNF的表达水平并进行比较。应用实时荧光定量PCR法检测血清中miR-134-5p的表达水平并进行比较。结果:两组患者治疗总有效率比较无统计学差异(P>0.05)。两组中局灶性发作患者和全面性发作患者治疗总有效率比较均无统计学差异(均P>0.05)。观察组治疗后SAS、SDS评分均明显低于对照组(均P<0.05)。观察组治疗后血清中BDNF的表达水平明显高于对照组,miR-134-5p的表达水平明显低于对照组(均P<0.05)。两组患者不良反应发生情况比较无统计学差异(P>0.05)。结论:左乙拉西坦对成人癫痫有较好的治疗效果,与丙戊酸钠有类似的作用。左乙拉西坦还能改善患者负性情绪,有效优化血清中BDNF和miR-134-5p的表达水平。

Objective:To observe the therapeutic effect of levetiracetam in the treatment of adult epilepsy,and analyze its effect on the expression of serum brain-derived neurotrophic factor(BDNF)and microRNA-134-5p(miR-134-5p)in patients.Methods:126 patients with adult epilepsy were divided into observation group(63 cases)and control group(63 cases).The control group was treated with valproate sodium,and the observation group was treated with levetiracetam for 12 months.Anxiety was analyzed by SAS,and depression was analyze by SDS after treatment,and the scores of SAS and SDS were compared between the two groups.BDNF was detected by ELISA,and miR-134-5p was detected by real-time PCR after treatment,and the levels of BDNF and miR-134-5p were compared between the two groups.Results:There was no statistical difference in the total effective rate of treatment between the two groups and(P>0.05).There was no significant difference in the total effective rate of treatment in patients with focal seizures and patients with generalized seizures between the two groups(all P>0.05).The SAS and SDS scores of the observation group after treatment were significantly lower than those of the control group(all P<0.05).After treatment,the expression level of BDNF in the serum of the observation group was significantly higher than that of the control group,and the expression level of miR-134-5p was significantly lower than that of the control group(all P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Levetiracetam is effective on adult epilepsy,similar to valproate sodium.Levetiracetam can also improve the negative emotions of patients,optimize the expression levels of BDNF and miR-134-5p.