左乙拉西坦联合丙戊酸钠治疗脑梗死后癫痫患者的效果

Effects of Levetiracetam combined with Sodium valproate in treatment of epilepsy after cerebral infarction

目的:观察左乙拉西坦联合丙戊酸钠治疗脑梗死后癫痫患者的效果。方法:选取2019年5月至2020年5月该院收治的74例脑梗死后癫痫患者进行前瞻性研究,按随机数字表法将其分成对照组与观察组各37例。对照组采用丙戊酸钠片治疗,观察组在对照组基础上联合左乙拉西坦片治疗,比较两组临床疗效、治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-2(IL-2)]水平、癫痫发作状况和不良反应发生率。结果:观察组治疗总有效率为97.30%(36/37),高于对照组的75.68%(28/37),差异有统计学意义(P<0.05);治疗后,两组TNF-α、IL-6、IL-2水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组癫痫发作持续时间均短于治疗前,且观察组短于对照组,两组发作频率均低于治疗前,且观察组低于对照组,差异有统计学意义(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:左乙拉西坦联合丙戊酸钠治疗脑梗死后癫痫患者可提高治疗总有效率,缩短癫痫发作持续时间,降低癫痫发作频率和炎性因子水平,其效果优于单纯丙戊酸钠治疗。

Objective:To observe effects of Levetiracetam combined with Sodium valproate in treatment of patients with epilepsy after cerebral infarction.Methods:A prospective study was conducted on 74 patients with epilepsy after cerebral infarction admitted to the hospital from May 2019 to May 2020.They were divided into control group and observation group according to the random number table method,37 cases in each group.The control group was treated with Sodium valproate tablets,while the observation group was treated with Levetiracetam tablets on the basis of that of the control group.The clinical efficacy,levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-2(IL-2)]before and after the treatment,the seizure status,and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 97.30%(36/37),which was higher than 75.68%(28/37)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of TNF-α,IL-6 and IL-2 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The seizure duration in the two groups were shorter than those before the treatment,and that of the observation group was shorter than that of the control group;the seizure frequencies of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Levetiracetam combined with Sodium valproate in the treatment of epilepsy after cerebral infarction can improve the total effective rate,shorten the seizure duration and reduce the seizure frequency and the inflammatory factor levels.Moreover,it is superior to single Sodium valproate treatment.