中国药房2016，Vol.27Issue(33)：4634-4637,4.DOI:10.6039/j.issn.1001-0408.2016.33.09
丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的临床观察
Clinical Observation of Sodium Valproate Combined with Levetiracetam in the Treatment of Post-stroke Epi-lepsy
摘要
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 epilepsy were randomly divided into control group (42 cases) and observation group(42 cases). All patients were given lowering lipid,lowering blood pressure,improving microcirculation,re-ducing intracranial pressure,anticoagulation,anti-platelet aggregation,cranial nerve protection and other conventional treatment, patients with status epilepticus were given stability control symptoms. Based on it,control group orally received Sodium valproate sustained-release tablet 15-20 mg/(kg·d),3 times a day,for 7 d,maintaining the dose if symptom was controlled;the dose in-creased to 20-30 mg/(kg·d)if it was not controlled,3 times a day. Observation group was additionally received Levetiracetam tab-let with initial dose of 0.25 g,twice a day,increased to 0.5 g after 7 d,maintaining the dose if symptom was controlled;then in-creased to 3 g if symptom was not controlled,twice a day. 2 groups of patients were continuous treated for 12 months,then de-creased Levetiracetam tablet 0.25 g weekly until complete withdrawal,patients with recurrence required lifelong medication. The clinical observation,times of seizures,seizure duration,epileptiform discharges,involved lead number,serum neuron specific eno-lase(NSE),TNF-α,IL-2 and IL-6 before and after treatment,the incidence of adverse reactions in 2 groups were observed. RE-SULTS:The total effective rate in observation group was significantly higher than control group,with statistical significance(P<0.05). Before treatment,there were no significant differences in the times of seizures,seizure duration,epileptiform discharges,in-volved lead number,NSE,TNF-α,IL-2 and IL-6 levels in 2 groups(P>0.05). After treatment,the times of seizures,seizure du-ration,epileptiform discharges,involved lead number,NSE,TNF-α,IL-2 and IL-6 levels in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significances(P<0.05). There was no significant difference in the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:Based on conventional treatment,the effi-cacy of sodium valproate combined with levetiracetam is significantly superior to sodium valproate alone in the treatment of post-stroke epilepsy,and do not increase the indence of adverse reactions.关键词
丙戊酸钠/左乙拉西坦/脑卒中后癫痫/疗效/安全性Key words
Sodium valproate/Levetiracetam/Post-stroke epilepsy/Efficacy/Safety分类
医药卫生引用本文复制引用
林岚,王晓燕,杨淑,唐浩,梅茸..丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的临床观察[J].中国药房,2016,27(33):4634-4637,4.基金项目
云南省医疗卫生单位内设研究机构科研项目 （）
