拉考沙胺联合奥卡西平治疗癫痫临床评价

Clinical Evaluation of Lacosamide Combined with Oxcarbazepine in the Treatment of Epilepsy

目的探讨拉考沙胺联合奥卡西平治疗癫痫的临床疗效及对患者脑损伤标志物水平的影响。方法选取作者所在医院2019年6月至2021年6月收治的癫痫患者105例,根据治疗方案的不同分为观察组(53例)和对照组(52例)。两组患者均口服奥卡西平片,观察组患者加服拉考沙胺片。两组均连续治疗12周。结果观察组总有效率为90.57%,显著高于对照组的75.00%(P<0.05)。治疗后,观察组患者的癫痫发作频率、癫痫样放电次数、累及导联数均显著小于对照组;认知功能筛查量表中注意力、定向力、记忆力、思维流畅性、语言表达力等项目评分均显著高于对照组;血清微小RNA-146a、同型半胱氨酸、细胞间黏附分子-1水平均显著低于对照组(P<0.05)。观察组与对照组不良反应发生率相当(15.09%比9.62%,P>0.05)。结论拉考沙胺联合奥卡西平治疗癫痫,可改善患者癫痫发作的症状和频率及认知功能,降低脑损伤标志物水平。

Objective To investigate the clinical efficacy of lacosamide combined with oxcarbazepine in the treatment of epilepsy and its effect on the level of brain injury markers.Methods A total of 105 patients with epilepsy admitted to the authors’hospital from June 2019 to June 2021 were selected and divided into the observation group(53 cases)and the control group(52 cases)according to different treatment schemes.The patients in the two groups took Oxcarbazepine Tablets orally,on this basis,the patients in the observation group took Lacosamide Tablets.Both groups were continuously treated for 12 weeks.Results The total effective rate in the observation group was 90.57%,which was significantly higher than 75.00%in the control group(P<0.05).After treatment,the frequency of seizures,the times of epileptiform discharges and the number of involved leads in the observation group were significantly lower than those in the control group(P<0.05).The scores of attention,orientation,memory,fluency of thinking and language expression in the Cognitive Ability Screening Scale(CASI)in the observation group were significantly higher than those in the control group(P<0.05).The levels of serum microRNA-146a(miR-146a),homocysteine(Hcy)and intercellular adhesion molecule-1(ICAM-1)in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse drug reactions in the observation group was similar to that in the control group(15.09%vs.9.62%,P>0.05).Conclusion Lacosamide combined with oxcarbazepine in the treatment of epilepsy can improve the symptoms and frequency of epileptic seizures and the patients’cognitive function,and reduce the level of brain injury markers.