摘要
目的探讨左乙拉西坦添加治疗对青年难治性癫痫患者认知功能、血清神经因子水平的影响与安全性。方法按照随机数字表法将中山大学附属第三医院粤东医院2019年1月至2020年12月收治的110例青年难治性癫痫患者分为对照组(55例,采用苯巴比妥、卡马西平常规疗法治疗)和观察组(55例,在对照组治疗的基础上联合左乙拉西坦添加疗法治疗),两组患者均治疗6个月。对比两组患者治疗3、6个月后临床疗效,治疗3、6个月后蒙特利尔认知评估量表(MOCA)评分、生存质量量表(QOLIE-31)评分,血清脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)及髓鞘碱性蛋白(MBP)水平,治疗期间不良反应发生情况。结果相较于对照组,治疗3、6个月后观察组患者临床总有效率均较高,治疗3、6个月后两组患者MOCA评分、QOLIE-31评分、血清BDNF水平与治疗前比均升高,且观察组高于对照组;相较于治疗前,治疗3、6个月后两组患者血清NSE、MBP水平均下降,且观察组下降幅度较对照组更大;相较于对照组患者不良反应总发生率(30.91%),观察组(10.91%)明显下降(均P<0.05)。结论将左乙拉西坦添加治疗用于青年难治性癫痫患者的治疗中,可有效缓解临床症状,抑制痫性发作,改善认知功能,使脑组织神经保护因子含量提高,并减轻神经组织损伤,提升其生活质量与治疗安全性。
Objective To investigate the effects of Levetiracetam add-on therapy on cognitive function and serum nerve factor levels of young patients with refractory epilepsy and its safety.Methods A total of 110 young patients with refractory epilepsy admitted to The Third Affiliated Hospital of Sun Yat-Sen University Yuedong Hospital from January 2019 to December 2020 were divided into the control group(55 cases,treated with phenobarbital and carbamazepine)and the observation group(55 cases,combined with levetiracetam add-on therapy on the basis of the control group)according to the random number table method,both groups were treated for 6 months.The clinical efficacy,Montreal Cognitive Assessment Scale(MOCA)score,Quality of Life Scale(QOLIE-31)score,serum levels of brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE)and myelin basic protein(MBP)of patients 3 and 6 months after treatment and the incidence of adverse reactions during treatment of patients in the two groups were compared.Results Compared with the control group,the total clinical effective rate was higher than that in the observation group 3 and 6 months after treatment,and the MOCA score,QOLIE-31 score,serum BDNF levels of patients in the two groups 3 and 6 months after treatment increased compared with before treatment,and the observation group was higher than the control group;the serum NSE and MBP levels of patients in the two groups 3 and 6 months after treatment decreased compared with before treatment,and the observation group was lower than the control group;compared with the control group,the total incidence of adverse reactions in the control group was 30.91%,and the observation group(10.91%)decreased significantly compared with that in the control group(all P<0.05).Conclusion Levetiracetam add-on therapy in the treatment of young patients with refractory epilepsy can effectively relieve clinical symptoms,inhibit epileptic seizures,improve cognitive function,increase the content of neuroprotective factors in brain tissue,alleviate nerve tissue damage,and improve the quality of life and treatment safety.
作者
梁玉婷
LIANG Yuting(Department of Neurology,The Third Affiliated Hospital of Sun Yat-Sen University Yuedong Hospital,Meizhou,Guangdong 514799,China)
