左乙拉西坦联合丙戊酸钠治疗老年局灶性癫痫临床观察

Clinical Observation of Levetiracetam Combined with Sodium Valproate in the Treatment of Elderly Patients with Focal Epilepsy

目的探讨左乙拉西坦联合丙戊酸钠治疗老年局灶性癫痫(FE)的临床疗效,以及对患者脑电图、神经、认知功能的影响。方法选取医院2020年1月至2022年12月收治的老年FE患者110例,按随机数字表法分为对照组和观察组,各55例。两组患者均口服丙戊酸钠缓释片,观察组患者加服左乙拉西坦片,均治疗6个月。结果观察组治疗总有效率为83.64%,显著高于对照组的65.45%(P<0.05);治疗后,观察组癫痫发作频率、癫痫持续时间、脑电图δ和θ频段功率、血清神经元特异性烯醇化酶水平均显著低于对照组(P<0.05),简易精神状态量表(MMSE)评分、脑电图α和β频段功率、血清脑源性神经营养因子水平均显著高于对照组(P<0.05);观察组和对照组不良反应发生率相当(30.91%比23.64%,P>0.05)。结论左乙拉西坦联合丙戊酸钠治疗老年FE的临床疗效良好,能有效控制患者癫痫的发作,改善脑电图,降低神经损害,提高认知功能,且安全性良好。

Objective To investigate the clinical efficacy of levetiracetam combined with sodium valproate in the treatment of elderly patients with focal epilepsy(FE),and its effects on patients′electroencephalogram,neurological,and cognitive functions.Methods A total of 110 elderly patients with FE admitted to the hospital from January 2020 to December 2022 were selected and divided into the control group and the observation group by the random number table method,with 55 cases in each group.The patients in the two groups were treated with Sustained-Release Sodium Valproate Tablets,while the patients in the observation group were additionally treated with Levetiracetam Tablets.Both groups were treated for six months.Results The total effective rate in the observation group was 83.64%,which was significantly higher than 65.45%in the control group(P<0.05).After treatment,the frequency of epileptic seizures,duration of seizures,δandθfrequency band power of electroencephalography,and serum neuron-specific enolase(NSE)level in the observation group were significantly lower than those in the control group(P<0.05),while the Mini-Mental State Examination(MMSE)score,αandβfrequency band power of electroencephalography,and serum brain-derived neurotrophic factor(BDNF)level in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions between the observation group and the control group was comparable(30.91%vs.23.64%,P>0.05).Conclusion Levetiracetam combined with sodium valproate has good clinical efficacy and safety in the treatment of elderly patients with FE,which can effectively control epileptic seizures,improve electroencephalography,reduce neurological damage,and enhance cognitive function.