左乙拉西坦联合拉莫三嗪治疗老年性癫痫患者的效果

Effects of Levetiracetam combined with Lamotrigine in treatment of senile epilepsy

目的:观察左乙拉西坦联合拉莫三嗪治疗老年性癫痫患者的效果。方法:选取2020年1月至2022年3月该院收治的76例老年性癫痫患者进行前瞻性研究,按随机数字表法将其分为研究组和对照组各38例。对照组予以拉莫三嗪治疗,研究组在对照组基础上联合左乙拉西坦治疗,比较两组临床疗效、临床症状改善情况,治疗前后基质金属蛋白酶-9(MMP-9)、神经元特异性烯醇化酶(NSE)水平,简易智力状态检查表(MMSE)、Barthel指数(BI)评分,炎性因子[白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)]水平,生命质量[生活质量综合评定量表(GQOLI-74)]评分,以及治疗期间不良反应发生率。结果:研究组治疗总有效率为94.74%(36/38),高于对照组的78.95%(30/38),差异有统计学意义(P<0.05);治疗后,研究组癫痫发作次数少于对照组,发作持续时间短于对照组,差异均有统计学意义(P<0.05);治疗后,研究组MMSE、BI、GQOLI-74评分均高于对照组,差异有统计学意义(P<0.05);治疗后,研究组MMP-9、NSE水平均低于对照组,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:左乙拉西坦联合拉莫三嗪治疗老年性癫痫患者可提高治疗总有效率和MMSE、BI、GQOLI-74评分,减少癫痫发作次数少,缩短癫痫发作持续时间,降低MMP-9和NSE水平,效果优于单纯拉莫三嗪治疗。

Objective:To observe effects of Levetiracetam combined with Lamotrigine in treatment of senile epilepsy.Methods:A prospective study was conducted on 76 patients with senile epilepsy admitted to this hospital from January 2020 to March 2022.They were divided into study group and control group according to the random number table method,38 cases in each.The control group was treated with Lamotrigine,while the study group was treated with Levetiracetam on the basis of that of the control group.The clinical efficacy,the improvement of clinical symptoms,the levels of matrix metalloproteinase-9(MMP-9)and neuron-specific enolase(NSE)before and after the treatment,the scores of minimental state examination(MMSE)and Barthel index(BI),the levels of inflammatory factors[interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)],the score of quality of life[general quality of life inventory(GQOLI-74)],and the incidence of adverse reactions during the treatment were compared between the two groups.Results:The total effective rate of treatment in the study group was 94.74%(36/38),which was higher than 78.95%(30/38)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the number of seizures in the study group was less than that in the control group,the duration of seizures was shorter than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of MMSE,BI and GQOLI-74 in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of MMP-9 and NSE in the study group were lower than those 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 Lamotrigine in the treatment of the senile epilepsy patients can improve the total effective rate of treatment and the MMSE,BI,GQOLI-74 scores,reduce the number of seizures,shorten the duration of seizures,and reduce the MMP-9 and NSE levels.Moreover,it is superior to single Lamotrigine treatment.