依达拉奉联合丙戊酸钠对脑卒中后继发癫痫患者的临床疗效、神经元特异性烯醇化酶、炎症因子及不良反应的研究
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摘要
目的探讨依达拉奉联合丙戊酸钠对脑卒中后继发癫痫(PSE)患者的神经元特异性烯醇化酶(NSE)、炎症因子及不良反应的影响及临床疗效。方法选取我院2015年10月至2016年10月收治的100例PSE患者,随机数字表法分为两组:在常规治疗基础上,对照组50例予丙戊酸钠;观察组50例予丙戊酸钠联合依达拉奉。治疗1年后,比较两组疗效、癫痫发作情况、NSE、炎症因子水平及安全性。结果1年后观察组总有效率92. 0%高于对照组的74. 0%(P <0. 05)。癫痫发作次数和持续时间少于对照组(P <0. 05)。1月末观察组NSE水平低于对照组(P <0. 05);在后续治疗中两组NSE水平无明显差异(P> 0. 05)。观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-2 (IL-2)和IL-8水平低于对照组(P <0. 05)。两组不良反应发生率分别为24. 0%和28. 0%,差异无统计学意义(P> 0. 05)。结论依达拉奉联合丙戊酸钠对PSE患者疗效显著,可显著降低NSE和炎症因子水平,且安全性较好。
Objective To investigate the clinical effect of edaravone combined with sodium valproate in the treatment of post-stroke epilepsy( PSE) and its influence on neuron-specific enolase( NSE),inflammatory factors,and adverse reactions. Methods A total of 100 patients who were admitted to our hospital from October 2015 to October 2016 were enrolled and randomly divided into control group and observation group,with 50 patients in each group. In addition to conventional treatment,the patients in the control group were given sodium valproate,and those in the observation group were given sodium valproate combined with edaravone. After 1 year of treatment,the two groups were compared in terms of clinical outcome,seizure,NSE,inflammatory factors,and safety. Results After1 year of treatment,the observation group had a significantly higher overall response rate than the control group( 92. 0% vs 74. 0%,P< 0. 05). The observation group had a significantly lower number of seizures and a significantly shorter duration of seizures than the control group( P < 0. 05). After 1 month of treatment,the observation group had a significantly lower level of NSE than the control group( P < 0. 05),while there was no significant difference between the two groups during the subsequent treatment( P > 0. 05). The observation group had significantly lower levels of tumor necrosis factor-α,interleukin-2,and interleukin-8 than the control group( P <0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( 24. 0% vs 28. 0%,P >0. 05). Conclusions Edaravone combined with sodium valproate has a marked clinical effect in patients with PSE and can significantly reduce the levels of NSE and inflammatory factors,with good safety.
Objective To investigate the clinical effect of edaravone combined with sodium valproate in the treatment of post-stroke epilepsy( PSE) and its influence on neuron-specific enolase( NSE),inflammatory factors,and adverse reactions. Methods A total of 100 patients who were admitted to our hospital from October 2015 to October 2016 were enrolled and randomly divided into control group and observation group,with 50 patients in each group. In addition to conventional treatment,the patients in the control group were given sodium valproate,and those in the observation group were given sodium valproate combined with edaravone. After 1 year of treatment,the two groups were compared in terms of clinical outcome,seizure,NSE,inflammatory factors,and safety. Results After1 year of treatment,the observation group had a significantly higher overall response rate than the control group( 92. 0% vs 74. 0%,P< 0. 05). The observation group had a significantly lower number of seizures and a significantly shorter duration of seizures than the control group( P < 0. 05). After 1 month of treatment,the observation group had a significantly lower level of NSE than the control group( P < 0. 05),while there was no significant difference between the two groups during the subsequent treatment( P > 0. 05). The observation group had significantly lower levels of tumor necrosis factor-α,interleukin-2,and interleukin-8 than the control group( P <0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( 24. 0% vs 28. 0%,P >0. 05). Conclusions Edaravone combined with sodium valproate has a marked clinical effect in patients with PSE and can significantly reduce the levels of NSE and inflammatory factors,with good safety.
引文
[1]姜春蕾.依达拉奉、丙戊酸钠联合治疗脑卒中后继发性癫痫的疗效[J].神经损伤与功能重建,2017,12(2):114-117.
[2]Zhao Y,Li X,Zhang K,et al.The Progress of Epilepsy after Stroke[J].Curr Neuropharmacol,2018,16(1):71-78.
[3]王晴,卢祖能.脑卒中后早期神经功能恶化[J].卒中与神经疾病,2017,24(1):80-83.
[4]徐菲,金平,王玉.脑卒中后癫痫发作的相关危险因素分析[J].中华疾病控制杂志,2017,21(2):179-182.
[5]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6]葛均波,徐永健.内科学(第8版)[D].人民卫生出版社,2013,1-944.
[7]杜蓉,徐碧芝.脑梗死患者继发性癫痫发生情况及高危因素调查[J].昆明医科大学学报,2018,43(4):100-103.
[8]边淑芳,王湘庆.卒中后痫性发作及卒中后癫痫的研究进展[J].解放军医学院学报,2017,38(3):245-246;249.
[9]赵岚青,于航,赵传胜.卒中后早期痫性发作危险因素分析及卒中急性期治疗对早期痫性发作的影响[J].国际神经病学神经外科学杂志,2018,45(5):486-491.
[10]Tanaka T,Ihara M.Post-stroke epilepsy[J].Neurochem Int,2017,107:219-228.
[11]蔡来新,李育新,牟晓莉.依达拉奉联合卡马西平治疗脑梗死后继发性癫痫的临床研究[J].现代药物与临床,2017,32(6):1002-1004.
[12]许长敏,张小健,刘晶晶.急性缺血性脑卒中应用醒脑静注射液联合依达拉奉注射液治疗的疗效观察[J].实用临床医药杂志,2017,21(13):161-162.
[13]Zheng J,Chen X.Edaravone offers neuroprotection for acute diabetic stroke patients[J].Ir J Med Sci,2016,185(4):819-824.
[14]胡浩,郁金泰,谭兰.卒中后癫痫发病机制及临床特点的探讨[J].中国卒中杂志,2017,12(4):336-339.
[15]郜俊峰,陈伟观,高志伟,等.脑血管病后癫痫的临床特征及危险因素分析[J].脑与神经疾病杂志,2017,25(10):607-610.
[16]郭育英,廖海燕,谢彩云,等.老年脑卒中患者癫痫发作的临床特点、脑电图表现及其危险因素分析[J].国际神经病学神经外科学杂志,2017,44(5):507-511.
[2]Zhao Y,Li X,Zhang K,et al.The Progress of Epilepsy after Stroke[J].Curr Neuropharmacol,2018,16(1):71-78.
[3]王晴,卢祖能.脑卒中后早期神经功能恶化[J].卒中与神经疾病,2017,24(1):80-83.
[4]徐菲,金平,王玉.脑卒中后癫痫发作的相关危险因素分析[J].中华疾病控制杂志,2017,21(2):179-182.
[5]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6]葛均波,徐永健.内科学(第8版)[D].人民卫生出版社,2013,1-944.
[7]杜蓉,徐碧芝.脑梗死患者继发性癫痫发生情况及高危因素调查[J].昆明医科大学学报,2018,43(4):100-103.
[8]边淑芳,王湘庆.卒中后痫性发作及卒中后癫痫的研究进展[J].解放军医学院学报,2017,38(3):245-246;249.
[9]赵岚青,于航,赵传胜.卒中后早期痫性发作危险因素分析及卒中急性期治疗对早期痫性发作的影响[J].国际神经病学神经外科学杂志,2018,45(5):486-491.
[10]Tanaka T,Ihara M.Post-stroke epilepsy[J].Neurochem Int,2017,107:219-228.
[11]蔡来新,李育新,牟晓莉.依达拉奉联合卡马西平治疗脑梗死后继发性癫痫的临床研究[J].现代药物与临床,2017,32(6):1002-1004.
[12]许长敏,张小健,刘晶晶.急性缺血性脑卒中应用醒脑静注射液联合依达拉奉注射液治疗的疗效观察[J].实用临床医药杂志,2017,21(13):161-162.
[13]Zheng J,Chen X.Edaravone offers neuroprotection for acute diabetic stroke patients[J].Ir J Med Sci,2016,185(4):819-824.
[14]胡浩,郁金泰,谭兰.卒中后癫痫发病机制及临床特点的探讨[J].中国卒中杂志,2017,12(4):336-339.
[15]郜俊峰,陈伟观,高志伟,等.脑血管病后癫痫的临床特征及危险因素分析[J].脑与神经疾病杂志,2017,25(10):607-610.
[16]郭育英,廖海燕,谢彩云,等.老年脑卒中患者癫痫发作的临床特点、脑电图表现及其危险因素分析[J].国际神经病学神经外科学杂志,2017,44(5):507-511.