丙戊酸钠缓释片对癫痫患者谷氨酸和γ-氨基丁酸及认知功能的影响
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摘要
目的分析丙戊酸钠缓释片对癫痫患者血浆谷氨酸(Glu)和γ-氨基丁酸(γ-GABA)水平变化及认知功能的改善情况。方法回顾性选取我院收治的癫痫患者79例,根据不同治疗方法分为对照组和观察组。对照组患者采用卡马西平,观察组患者采用丙戊酸钠缓释片,2组均连续治疗6个月。观测2组患者治疗后的疗效、睡眠状况、认知功能、Glu、γ-GABA、脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)和超氧化物歧化酶(SOD)水平的变化情况。结果治疗后,观察组治愈13例,显效17例,有效8例,总有效率(90.48%)高于对照组(P<0.05);2组患者的Glu、γ-GABA、NSE及SOD水平均较治疗前下降,观察组低于对照组(P<0.05);BDNF水平较治疗前上升,观察组高于对照组(P<0.05);2组患者睡眠状况均较治疗前改善,但组间比较差异无统计学意义(P>0.05);2组患者认知功能较治疗前均改善,观察组优于对照组(P<0.05)。结论丙戊酸钠缓释片治疗癫痫患者疗效确切,可改善患者睡眠状况和认知功能,降低患者Glu、γ-GABA、NSE及SOD水平。
Objective To investigate the changes of plasma glutamic acid(Glu),γ-aminobutyric acid(γ-GABA) and cognitive function in epileptic patients after taking Sodium Valproate Sustained Release Tablets.Methods 79 cases of patients with epilepsy were retrospectively selected in our hospital,according to the different treatment methods,and divided into control group and observation group.The control group was treated with carbamazepine therapy,while the observation group were treated with Sodium Valproate Sustained Release Tablets.Both of the 2 groups were treated for 6 months.The efficacy,the cognitive function,Glu,γ-GABA,brain-derived neurotrophic factor(BDNF),neuron specific enolase(NSE) and superoxide dismutase(SOD) levels of the 2 groups were observed and compared.Results Patients in the observation group after treatment,13 cases were cured,17 cases markedly effective,and 8 cases effective.The total effective rate was 90.48% higher than that of the control group(P<0.05).The Glu,γ-GABA,NSE and SOD levels of the 2 groups after treatment were lower than that before treatment,while the level of BDNF was increased(P<0.05).The Glu,γ-GABA,NSE and SOD levels of the observation group after treatment were lower than that of the control group,while the level of BDNF was higher than that of the control group(P<0.05).The sleep status of the 2 groups after treatment was improved, but no statistically significant difference was observed between the groups(P>0.05).The cognitive function of the 2 groups was improved after treatment,and the cognitive function of the observation group after treatment was better than that of the control group(P<0.05).Conclusion Sodium Valproate Sustained Release Tablets is effective in the treatment of epilepsy,which can improve the sleep and cognitive function of patients,and reduce the levels of Glu,γ-GABA,NSE and SOD in patients with epilepsy.
Objective To investigate the changes of plasma glutamic acid(Glu),γ-aminobutyric acid(γ-GABA) and cognitive function in epileptic patients after taking Sodium Valproate Sustained Release Tablets.Methods 79 cases of patients with epilepsy were retrospectively selected in our hospital,according to the different treatment methods,and divided into control group and observation group.The control group was treated with carbamazepine therapy,while the observation group were treated with Sodium Valproate Sustained Release Tablets.Both of the 2 groups were treated for 6 months.The efficacy,the cognitive function,Glu,γ-GABA,brain-derived neurotrophic factor(BDNF),neuron specific enolase(NSE) and superoxide dismutase(SOD) levels of the 2 groups were observed and compared.Results Patients in the observation group after treatment,13 cases were cured,17 cases markedly effective,and 8 cases effective.The total effective rate was 90.48% higher than that of the control group(P<0.05).The Glu,γ-GABA,NSE and SOD levels of the 2 groups after treatment were lower than that before treatment,while the level of BDNF was increased(P<0.05).The Glu,γ-GABA,NSE and SOD levels of the observation group after treatment were lower than that of the control group,while the level of BDNF was higher than that of the control group(P<0.05).The sleep status of the 2 groups after treatment was improved, but no statistically significant difference was observed between the groups(P>0.05).The cognitive function of the 2 groups was improved after treatment,and the cognitive function of the observation group after treatment was better than that of the control group(P<0.05).Conclusion Sodium Valproate Sustained Release Tablets is effective in the treatment of epilepsy,which can improve the sleep and cognitive function of patients,and reduce the levels of Glu,γ-GABA,NSE and SOD in patients with epilepsy.
引文
[1] 许毛,马小亚,黄绍平,等.HPLC法测定癫痫患者血清中拉莫三嗪质量浓度[J].西北药学杂志,2017,32(6):754-757.
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[13] Losurdo A,Proserpio P,Cardinale F,et al.Drug-resistant focal sleep related epilepsy:results and predictors of surgical outcome[J].Epilepsy Res,2014,108(5):953-962.
[14] Thomson A E,Calle A,Fontela M E,et al.Screening of major depression in epilepsy:the neurologic depression disorders inventory in epilepsy-spanish version (Argentina)[J].Epilepsia,2014,55(2):331-334.
[15] 庄梅琳,陈琳琳,谢志新.4种常见水果T-SOD协同清除自由基能力的比较[J].海峡药学,2016,28(4):247-250.
[16] Xu P,Xiong X,Xue Q,et al.Differentiating between psychogenic nonepileptic seizures and epilepsy based on common spatial pattern of weighted EEG resting networks[J].IEEE Transact Biomed Eng,2014,61(6):1747-1755.
[17] Matricardi S,Verrotti A,Chiarelli F,et al.Current advances in childhood absence epilepsy[J].Pediatr Neurol,2014,50(3):205-212.
[2] 陈剑峰,张美胡.丙戊酸钠缓释片对癫痫患者氧化应激系统及认知功能的影响[J].海南医学院学报,2017,23(6):841-843.
[3] Mole T B,Appleton R,Marson A,et al.Withholding the choice of sodium valproate to young women with generalised epilepsy:are we causing more harm than good?[J].Seizure,2015,24:127-130.
[4] Chandra S R,Issac T G,Gayathri N,et al.A typical case of myoclonic epilepsy with ragged red fibers (MERRF) and the lessons learned[J].J Postqrad Med,2015,61(3):200-202.
[5] Pritchard D,Hoerger M,Dyer T,et al.Sodium valproate withdrawal correlates with reduced aggression[J].Br J learn disabils,2014,42(2):162-167.
[6] 刘朝阳,伍国锋,王丽琨.γ-氨基丁酸受体在癫痫中的研究进展[J].中华神经医学杂志,2016,15(3):306-309.
[7] Mondal S,Dhondge S S,Paliwal L J,et al.Physicochemical properties of an anticonvulsant drug sodium valproate in aqueous and in mixed aqueous solutions at different temperatures[J].J Chem Thermodynam,2015,90:147-157.
[8] Pickrell W O,Lacey A S,Thomas R H,et al.Trends in the first antiepileptic drug prescribed for epilepsy between 2000 and 2010[J].Seizure,2014,23(1):77-80.
[9] 张萌,吴海琴,王虎清.BDNF在神经系统疾病中的作用机制[J].卒中与神经疾病,2013,20(6):384-387.
[10] Patra S,Elisevich K,Podell K,et al.Influence of age and location of ictal onset on postoperative outcome in patients with localization-related epilepsy[J].Br J Neurosurg,2014,28(1):61-67.
[11] Alexandre Teixeira C,Direito B,Bandarabadi M,et al.Epileptic seizure predictors based on computational intelligence techniques:a comparative study with 278 patients[J].Comput Methods Progroms Biomed,2014,114(3):324-336.
[12] 幸勇,马凌飞,柏占锋,等.115例癫痫患者丙戊酸钠血药质量浓度的监测与分析[J].西北药学杂志,2017,32(1):99-101.
[13] Losurdo A,Proserpio P,Cardinale F,et al.Drug-resistant focal sleep related epilepsy:results and predictors of surgical outcome[J].Epilepsy Res,2014,108(5):953-962.
[14] Thomson A E,Calle A,Fontela M E,et al.Screening of major depression in epilepsy:the neurologic depression disorders inventory in epilepsy-spanish version (Argentina)[J].Epilepsia,2014,55(2):331-334.
[15] 庄梅琳,陈琳琳,谢志新.4种常见水果T-SOD协同清除自由基能力的比较[J].海峡药学,2016,28(4):247-250.
[16] Xu P,Xiong X,Xue Q,et al.Differentiating between psychogenic nonepileptic seizures and epilepsy based on common spatial pattern of weighted EEG resting networks[J].IEEE Transact Biomed Eng,2014,61(6):1747-1755.
[17] Matricardi S,Verrotti A,Chiarelli F,et al.Current advances in childhood absence epilepsy[J].Pediatr Neurol,2014,50(3):205-212.