托吡酯与卡马西平治疗对脑梗死后继发癫痫患者神经功能缺损、日常活动能力及认知功能的影响

The effects of topiramate and carbamazepine on neurological deficits,daily activities and cognitive functions in patients with secondary epilepsy after cerebral infarction

目的分析托吡酯与卡马西平治疗对脑梗死后继发癫痫患者神经功能缺损、日常活动能力和认知功能的影响,为临床治疗提供思路。方法选取2017年3月至2019年8月我院收入的脑梗死后继发癫痫138例患者。按随机数字表法分为A组(治疗上加以卡马西平)和B组(治疗上加以托吡酯)各69例。治疗6个月后比较两组临床效果,治疗前后神经功能缺损、日常活动能力和认知功能的评分及不良反应发生情况。结果治疗后B组疗效高于A组(P<0.05);B组神经功能缺损较治疗前明显下降,且低于A组,不同时间评估分神经功能缺损情况差异有统计学意义(P<0.001);两组日常活动能力和认知功能评分均较治疗前升高,且B组评分高于A组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论托吡酯的临床疗效优于卡马西平,对脑梗死后继发癫痫患者的预后恢复疗效更好,且不良反应程度轻微,值得临床推广。

Objective To analyze the effects of topiramate and carbamazepine on neurological deficits,daily activities and cognitive functions in patients with secondary epilepsy after cerebral infarction in order to ideas for clinical treatment.Methods One hundred and thirty-eight patients with epilepsy secondary to cerebral infarction were selected from March 2017 to August 2019 in our hospital were selected.According to different treatment methods,they were divided into group A treated with carbamazepine and group B treated with topiramate,69 in each group.After 6 months of treatment,the clinical effects,neurological deficits before and after treatment,daily activity ability and cognitive function scores as well as adverse reactions were compared between the two groups.Results The curative effect of the group B was higher than that of group A(P<0.05).The neurological deficits in the group B were significantly decreased when compared to before treatment and lower than that in the group A.There were significant differences in the neurological deficits at different time(P<0.001).After treatment,the daily activity ability and cognitive function of the two groups were higher than those before treatment,and the scores in the group B was higher than that in the group A(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The clinical efficacy of topiramate is better than that of carbamazepine.It has a better prognostic recovery effect on patients with secondary epilepsy after cerebral infarction,and has higher safety.It is worthy of clinical promotion.