丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的临床观察

发布时间：2019-07-21 16:54

【摘要】：目的:观察丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的疗效和安全性。方法:84例脑卒中后癫痫患者随机分为对照组(42例)和观察组(42例)。两组患者均给予降血脂、降血压、改善微循环、降低颅内压、抗凝、抗血小板聚集及脑神经保护药等常规治疗,对于癫痫持续状态患者酌情给予地西泮控制症状。在此基础上,对照组患者口服丙戊酸钠缓释片15~20 mg/(kg·d),每日3次,连用7 d,若症状得到控制则维持此剂量;若症状未得到控制则增加剂量至20~30 mg/(kg·d),每日3次。观察组患者在对照组治疗的基础上口服左乙拉西坦片初始剂量0.25 g,每日2次,连用7 d后增加剂量至0.5 g,每日2次,若症状得到控制则维持此剂量;若症状未得到控制则增加剂量至3 g,每日2次。两组患者均连续用药12个月,后每周减少左乙拉西坦片0.25 g至完全停药,对于停药后复发者需终身用药。观察两组患者的临床疗效、治疗前后癫痫发作次数、发作持续时间、痫样放电、累及导联数、神经元特异性烯醇化酶(NSE)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-2、IL-6水平及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P0.05)。治疗前,两组患者癫痫发作次数、发作持续时间、痫样放电、累及导联数、NSE、TNF-α、IL-2、IL-6水平比较,差异均无统计学意义(P0.05)。治疗后,两组患者癫痫发作次数、发作持续时间、痫样放电、累及导联数、NSE、TNF-α、IL-2、IL-6水平均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P0.05)。两组患者不良反应发生率比较差异无统计学意义(P0.05)。结论:在常规治疗的基础上,丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的疗效显著优于单用丙戊酸钠,且不增加不良反应的发生。
[Abstract]:Objective: to observe the efficacy and safety of sodium valproate combined with levetiracetam in the treatment of post-stroke epilepsy. Methods: 84 patients with post-stroke seizures were randomly divided into control group (n = 42) and observation group (n = 42). The patients in both groups were given routine treatment such as lowering blood lipid, lowering blood pressure, improving microcirculation, reducing intracranial pressure, anticoagulation, antiplatelet aggregation and cerebral neuroprotective drugs, and diazepam was given diazepam as appropriate to control the symptoms. On this basis, the patients in the control group were given sodium valproate sustained-release tablets 15 鈮，

本文编号：2517310