奥卡西平与左乙拉西坦治疗部分性癫痫发作的效果及不良反应比较
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摘要
目的比较奥卡西平与左乙拉西坦治疗部分性癫痫发作的效果及不良反应。方法选取2016年10月至2018年2月医院收治的84例部分性癫痫发作患者为研究对象,按随机数字表法将其分为奥卡西平组和左乙拉西坦组,各42例。奥卡西平组患者给予奥卡西平治疗,左乙拉西坦组患者给予左乙拉西坦治疗。比较两组患者的临床疗效、脑电图间歇期痫性放电(IEA)变化以及不良反应发生情况,同时比较两组患者治疗前、后的言语智商(VIQ)、操作智商(PIQ)、总智商(FIQ)评分及脑电α、β、δ、θ波相对功率。结果奥卡西平组的治疗总有效率明显高于左乙拉西坦组(P<0.05)。治疗后,两组IEA变化及不良反应总发生率比较,差异均不显著(P>0.05)。治疗后,两组患者VIQ、PIQ、FIQ评分及α、β、δ、θ波相对功率的变化均无显著差异(P>0.05)。结论奥卡西平治疗部分性癫痫发作的效果优于左乙拉西坦,奥卡西平与左乙拉西坦的不良反应相似,且对脑电背景活动无明显影响。
Objective To compare the effect and adverse reactions of oxcarbazepine and levetiracetam in the treatment of partial seizures. Methods Eighty-four patients with partial seizures admitted in our hospital from October 2016 to February 2018 were selected as the study objects. The patients were divided into oxcarbazepine group and levetiracetam group according to random number table method, with 42 cases in each group. The oxcarbazepine group was treated with oxcarbazepine, and the levetiracetam group was treated with levetiracetam. The clinical efficacy, changes of electroencephalogram intermittent epileptic activity(IEA) and the incidence of adverse reactions were compared between the two groups. The scores of verbal intelligence quotient(VIQ), performances intelligence quotient(PIQ) and full intelligence quotient(FIQ), relative power of α, β, δ and θ waves of electroencephalogram before and after treatment were also compared between the two groups. Results The total effective rate of treatment in the oxcarbazepine group was significantly higher than that in the levetiracetam group(P<0.05). After treatment, there were no significant differences in IEA changes and the total incidence of adverse reactions between the two groups(P>0.05). After treatment, there were no significant differences in the scores of VIQ, PIQ and FIQ and the relative power of α, β, δ and θ waves between the two groups(P>0.05). Conclusion Oxcarbazepine is superior to levetiracetam in the treatment of partial seizures. The adverse reactions of oxcarbazepine and levetiracetam are similar, and there is no significant effect on the background activity of electroencephalogram.
Objective To compare the effect and adverse reactions of oxcarbazepine and levetiracetam in the treatment of partial seizures. Methods Eighty-four patients with partial seizures admitted in our hospital from October 2016 to February 2018 were selected as the study objects. The patients were divided into oxcarbazepine group and levetiracetam group according to random number table method, with 42 cases in each group. The oxcarbazepine group was treated with oxcarbazepine, and the levetiracetam group was treated with levetiracetam. The clinical efficacy, changes of electroencephalogram intermittent epileptic activity(IEA) and the incidence of adverse reactions were compared between the two groups. The scores of verbal intelligence quotient(VIQ), performances intelligence quotient(PIQ) and full intelligence quotient(FIQ), relative power of α, β, δ and θ waves of electroencephalogram before and after treatment were also compared between the two groups. Results The total effective rate of treatment in the oxcarbazepine group was significantly higher than that in the levetiracetam group(P<0.05). After treatment, there were no significant differences in IEA changes and the total incidence of adverse reactions between the two groups(P>0.05). After treatment, there were no significant differences in the scores of VIQ, PIQ and FIQ and the relative power of α, β, δ and θ waves between the two groups(P>0.05). Conclusion Oxcarbazepine is superior to levetiracetam in the treatment of partial seizures. The adverse reactions of oxcarbazepine and levetiracetam are similar, and there is no significant effect on the background activity of electroencephalogram.
引文
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[9]MECARELLI O,LI VOTI P,PRO S,et al.Saliva and serum levetiracetam concentrations in patients with epilepsy[J].Ther Drug Monit,2007,29(3):313-318.
[10]PERUCCA E.Pharmacokinetic variability of new antiepileptic drugs at different ages[J].Ther Drug Monit,2005,27(6):714-717.
[11]季茉.左乙拉西坦治疗小儿癫痫临床疗效及对脑电图、智力改善作用[J].临床军医杂志,2017,45(8):865-867.
[12]MANCHON JF,DABAGHIAN Y,UZOR NE,et al.Levetiracetam mitigates doxorubicin-induced DNA and synaptic damage in neurons[J].Sci Rep,2016,6:25705.
[13]李世敬,来华安.不同药物治疗部分性发作癫痫疗效及对脑电图的影响[J].西南国防医药,2016,26(11):1236-1238.
[14]刘远昌.两种抗癫痫单药方案对部分性发作癫痫患儿临床疗效及安全性[J].临床军医杂志,2017,45(11):1171-1173.
[2]AKSOY D,G譈VELI BT,AK PD,et al.Effects of oxcarbazepine and levetiracetam on calcium,ionized calcium,and 25-OH vitamin-D3levels in patients with epilepsy[J].Clin Psychopharmacol Neurosci,2016,14(1):74-78.
[3]李志斌,江慧敏,肖华.奥卡西平联合左乙拉西坦治疗小儿癫痫的疗效及安全性[J].实用医学杂志,2016,32(16):2734-2736.
[4]SUNWOO JS,PARK BS,AHN SJ,et al.Three-year retention rates of levetiracetam,topiramate,and oxcarbazepine:a retrospective hospital-based study[J].Clin Neuropharmacol,2017,40(2):56-62.
[5]侯蕴祈,欧阳基鹏,游文霞,等.奥卡西平和左乙拉西坦治疗新诊断部分性发作癫疒间患儿的疗效分析[J].实用药物与临床,2015,18(2):160-164.
[6]吴逊,李文慧.国际抗癫痫联盟和名词委员会推荐的癫痫发作的临床及脑电图分类[J].中华神经科杂志,2001,34(3):187-188.
[7]中华医学会.临床诊疗指南.癫痫病分册[M].北京:人民卫生出版社,2007,30(2):53-55.
[8]戴晓阳,龚耀先.韦氏成人智力量表中国修订版(WAIS-RC)的离散分析[J].心理科学,1988,11(4):23-28.
[9]MECARELLI O,LI VOTI P,PRO S,et al.Saliva and serum levetiracetam concentrations in patients with epilepsy[J].Ther Drug Monit,2007,29(3):313-318.
[10]PERUCCA E.Pharmacokinetic variability of new antiepileptic drugs at different ages[J].Ther Drug Monit,2005,27(6):714-717.
[11]季茉.左乙拉西坦治疗小儿癫痫临床疗效及对脑电图、智力改善作用[J].临床军医杂志,2017,45(8):865-867.
[12]MANCHON JF,DABAGHIAN Y,UZOR NE,et al.Levetiracetam mitigates doxorubicin-induced DNA and synaptic damage in neurons[J].Sci Rep,2016,6:25705.
[13]李世敬,来华安.不同药物治疗部分性发作癫痫疗效及对脑电图的影响[J].西南国防医药,2016,26(11):1236-1238.
[14]刘远昌.两种抗癫痫单药方案对部分性发作癫痫患儿临床疗效及安全性[J].临床军医杂志,2017,45(11):1171-1173.