摘要
目的:探讨用左乙拉西坦治疗首诊癫的疗效及对病人骨代谢和骨密度的影响。方法:选取2015年6月-2017年5月解放军第一O一医院收治的首诊癫病人66例,分为A组(左乙拉西坦片治疗,33例)和B组(卡马西平治疗,33例),比较两组病人的疗效、药品不良反应(ADRs)及治疗前、治疗后6个月骨代谢和骨密度水平。结果:A组病人与B组病人治疗总有效率比较差异无统计学意义。两组病人头晕、头痛、嗜睡、恶心、呕吐、肝功能损伤、情绪改变发生率比较差异无统计学意义。治疗前,两组病人血钙、血磷、碱性磷酸酶、甲状旁腺激素水平比较差异也无统计学意义。治疗6个月后,B组病人血钙水平低于A组及自身治疗前,血磷、碱性磷酸酶水平高于A组及自身治疗前(P<0.05)。治疗前,两组病人腰椎、股骨大转子、股骨颈、Ward三角骨密度水平比较差异无统计学意义;治疗6个月后,B组病人股骨大转子、股骨颈、Ward三角骨密度较自身治疗前均显著下降(P<0.05);A组病人这些部位骨密度与治疗前比较差异无统计学意义。结论:用左乙拉西坦治疗首诊癫病人具有显著疗效和较高用药安全性,相对卡马西平能减轻对病人骨代谢和骨密度的影响。
Objective:To investigate the curative effects of levetiracetam on the patients with first diagnosed epilepsy,as well as bone metabolism and bone mineral density(BMD).Methods:Totally,66 cases of first diagnosed epilepsy treated in No.101 Hospital of PLA from June 2015 to May 2017 were enrolled as study subjects,and were divided into group A(with levetiracetam treatment,n=33)and group B(with carbamazepine treatment,n=33).The curative effects,adverse drug reactions(ADRs),bone metabolism and BMD before treatment and 6 months after treatment were compared between the patients of the 2 groups.Results:Total effective rate of the patients in group A and group B was not statistically different.The rates of dizziness,headache,drowsiness,nausea and vomiting,hepatic function injury and mood change in the patients of both groups were also not statistically different.There was no statistical significance in the levels of serum calcium,phosphorus,alkaline phosphatase and parathyroid hormone,when comparisons were made between the 2 groups before treatment.However,6 months after treatment,the level of serum calcium in group B was lower than that of group A,and was also lower than that of itself before treatment.The levels of serum phosphorus and alkaline phosphatase in group B were higher than those of group A and were also higher than those itself before treatment(P<0.05).Before treatment,there was no statistical significance in the bone mass density of lumbar vertebrae,femoral trochanter,femoral neck and Ward triangle in the 2 groups.However,after 6 months of treatment,the BMD of femoral trochanter,femoral neck and Ward triangle of group B decreased significantly,as compared with that before treatment(P<0.05),while for the patients of group A,there were no statistical differences in the BMD of these sites,when comparisons were made with those before treatment(P>0.05).Conclusion:Levetiracetam in the treatment of patients with first diagnosed epilepsy could produce significant curative effects with high medication safety.Furthermore,it could lower the impact on bone metabolism and BMD,as compared with carbamazepine.
引文
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