拉莫三嗪联合小剂量丙戊酸钠治疗初诊癫痫的效果及对脑电图指标的影响

Effect of lamotrigine combined with low-dose sodium valproate in the treatment of newly diagnosed epilepsy and its influences on electroencephalogram indexes

目的探究拉莫三嗪联合小剂量丙戊酸钠治疗初诊癫痫的效果及对脑电图指标的影响。方法选取2020年4月至2022年4月收治的100例初诊癫痫患者为研究对象,按照随机数字表法将其分为对照组与观察组,各50例。对照组采用小剂量丙戊酸钠治疗,观察组在对照组基础上增加拉莫三嗪治疗。比较两组的癫痫发作频率、发作持续时间、脑电图指标、神经功能及认知功能。结果治疗后,观察组的癫痫发作频率低于对照组,发作持续时间短于对照组(P<0.05)。治疗后,观察组的δ波、痫样放电、累及导联数低于对照组,θ波高于对照组(P<0.05)。治疗后,观察组的神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)水平低于对照组,简易智力状况检查法(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组(P<0.05)。结论拉莫三嗪联合小剂量丙戊酸钠治疗初诊癫痫效果明显,不仅能够改善脑电图指标,还能降低神经细胞受损程度,促进患者认知功能恢复。

Objective To explore the effect of lamotrigine combined with low-dose sodium valproate in the treatment of newly diagnosed epilepsy and its influences on electroencephalogram indexes.Methods A total of 100 patients with newly diagnosed epilepsy admitted from April 2020 to April 2022 were selected as the research objects,and the patient were divided into control group and observation group according to the random number table method,with 50 cases in each group.The control group was treated with low-dose sodium valproate,and the observation group was treated with lamotrigine on the basis of the control group.The frequency of seizures,duration of seizures,electroencephalogram indexes,neurological function and cognitive function were compared between the two groups.Results After treatment,the frequency of epileptic seizures in the observation group was lower than that in the control group,and the duration of seizures was shorter than that in the control group(P<0.05).After treatment,theδwave,epileptic discharge and the number of involved leads of the observation group were lower than those of the control group,and theθwave was higher than that of the control group(P<0.05).After treatment,the levels of neuron-specific enolase(NSE)and myelin basic protein(MBP)in the observation group were lower than those in the control group,the scores of Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)were higher than those of the control group(P<0.05).Conclusion The lamotrigine combined with low-dose sodium valproate in the treatment of newly diagnosed epilepsy has obvious effect.It can not only improve the electroencephalogram indexes,but also reduce the degree of nerve cell damage and promote the recovery of cognitive function.