拉莫三嗪联合丙戊酸钠预防卒中后痫性发作的临床有效率分析
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摘要
目的探讨拉莫三嗪联合丙戊酸钠预防脑卒中继发性癫痫的临床有效率。方法研究对象为2012年3月—2016年4月间符合标准的卒中后痫性发作的高危患者,随机分为两组,即为观察组与不用预防药物(对照组);随访观察2年左右时间,研究对早发痫性发作、迟发痫性发作及癫痫预防作用。结果①两组在基线对比中差异无统计学意义(P<0.05)。②早发型痫性发作及早发癫痫:发病率(χ~2=16.87,P=0.01)、发作时间持续(χ~2=68.51,P=0.01)比较,观察组明显低于对照组,差异有统计学意义;③迟发型痫性发作及癫痫:发病率(χ~2=0.03,P=0.87)、发作时间持续(χ~2=0.14,P=0.74)比较观察组与对照组没有统计学差异;④首次痫性发作时间:观察组卒中后首次癫痫发作间隔时间长于对照组,差异有统计学意义(χ~2=94.12,P=0.01)。结论卒中后痫性发作的高危人群早期、短期应用拉莫三嗪联合丙戊酸钠治疗早发性痫性发作、癫痫较高的预防作用;但对迟发痫性发作及癫痫无预防作用。
Objective To investigate the clinical efficacy of lamotrigine combined with sodium valproate in the prevention of stroke-induced epilepsy. Methods High-risk patients with post-stroke seizures who met the criteria from March 2012 to April 2016 were randomly divided into two groups: the observation group and the non-prophylaxis(control group.) Follow-up observation lasted 2 years or so. The prevention of early epileptic seizures, late seizures and epilepsy were studied. Results 1.There was no significant difference between the two groups in the baseline comparison(P <0.05). 2. Early onset seizures and early onset epilepsy: incidence rate(χ~2=16.87, P=0.01), and duration of onset(χ~2=68.51, P= 0.01) of the observation group were significantly lower than those of the control group, there was statistical difference. 3. Late onset seizures and epilepsy: incidence rate(χ~2=0.03, P=0.87), and duration of onset(χ~2=0.14, P=0.74) in the observation group were not statistically different from those in the control group. 4. First epileptic seizure time: The interval between the first epileptic seizures in the observation group was longer than that in the control group,and the difference was a statistically significant(χ~2=94.12, P=0.01). Conclusion Early and short-term use of lamotrigine combined with sodium valproate in the treatment of high-risk episodes of post-stroke seizures has a preventive effect on early onset seizures and epilepsy. However, it has no preventive effect on late seizures and epilepsy.
Objective To investigate the clinical efficacy of lamotrigine combined with sodium valproate in the prevention of stroke-induced epilepsy. Methods High-risk patients with post-stroke seizures who met the criteria from March 2012 to April 2016 were randomly divided into two groups: the observation group and the non-prophylaxis(control group.) Follow-up observation lasted 2 years or so. The prevention of early epileptic seizures, late seizures and epilepsy were studied. Results 1.There was no significant difference between the two groups in the baseline comparison(P <0.05). 2. Early onset seizures and early onset epilepsy: incidence rate(χ~2=16.87, P=0.01), and duration of onset(χ~2=68.51, P= 0.01) of the observation group were significantly lower than those of the control group, there was statistical difference. 3. Late onset seizures and epilepsy: incidence rate(χ~2=0.03, P=0.87), and duration of onset(χ~2=0.14, P=0.74) in the observation group were not statistically different from those in the control group. 4. First epileptic seizure time: The interval between the first epileptic seizures in the observation group was longer than that in the control group,and the difference was a statistically significant(χ~2=94.12, P=0.01). Conclusion Early and short-term use of lamotrigine combined with sodium valproate in the treatment of high-risk episodes of post-stroke seizures has a preventive effect on early onset seizures and epilepsy. However, it has no preventive effect on late seizures and epilepsy.
引文
[1]van Tuijl JH,van Raak EP,de Krom MC,et al.Early treatment after stroke for the prevention of late epileptic seizures:a report on the problems performing a randomised placebo-controlled double-blind trial aimed at anti-epileptogenesis[J].Seizure,2011,20(4):285-291.
[2]郭强,姚力.拉莫三嗪联合丙戊酸钠治疗脑卒中继发性癫痫的疗效分析[J].药物评价研究,2015,38(4):405-408.
[3]HaapaniemiE,StrbianD,RossiC,et al.The CAVE score for predicting late seizures after intracerebral hemorrhage[J].Stroke,2014,45(7):1971-1976.
[4]Galovic M,D hler N,Erdélyi-Canavese B,et al.Prediction of late seizures after ischaemic stroke with a novel prognostic model(the SeLECT score):a multivariable prediction model development and validation study s[J].Lancet Neurol.2018,17(2):143-152.
[5]Chan L,Hu CJ,Fan YC,et al.Incidence of poststroke seizu res:A meta-analysis[J].J Clin Neurosci 2018,47:347-345.
[6]Yang H,Rajah G,Guo A,et al.Pathogenesis of epileptic seizures and epilepsy after stroke[J].Neurol Res.2018,40(6):426-432.
[7]周定富.拉莫三嗪联合丙戊酸钠对难治性小儿癫痫认知功能及炎症因子水平的影响[J].长江大学学报:自科版,2018,15(4):20-21.
[8]Rodríguez Lucci F Alet M,Ameriso SF.Post-stroke epilepsy[J].Medicina(B Aires),2018,78(2):86-90.
[2]郭强,姚力.拉莫三嗪联合丙戊酸钠治疗脑卒中继发性癫痫的疗效分析[J].药物评价研究,2015,38(4):405-408.
[3]HaapaniemiE,StrbianD,RossiC,et al.The CAVE score for predicting late seizures after intracerebral hemorrhage[J].Stroke,2014,45(7):1971-1976.
[4]Galovic M,D hler N,Erdélyi-Canavese B,et al.Prediction of late seizures after ischaemic stroke with a novel prognostic model(the SeLECT score):a multivariable prediction model development and validation study s[J].Lancet Neurol.2018,17(2):143-152.
[5]Chan L,Hu CJ,Fan YC,et al.Incidence of poststroke seizu res:A meta-analysis[J].J Clin Neurosci 2018,47:347-345.
[6]Yang H,Rajah G,Guo A,et al.Pathogenesis of epileptic seizures and epilepsy after stroke[J].Neurol Res.2018,40(6):426-432.
[7]周定富.拉莫三嗪联合丙戊酸钠对难治性小儿癫痫认知功能及炎症因子水平的影响[J].长江大学学报:自科版,2018,15(4):20-21.
[8]Rodríguez Lucci F Alet M,Ameriso SF.Post-stroke epilepsy[J].Medicina(B Aires),2018,78(2):86-90.