發(fā)布時間：2018-03-13 18:30

  本文選題：卒中后癲癇　切入點：抗癲癇藥物　出處：《臨床神經(jīng)病學(xué)雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的探討4種常用抗癲癇藥物(AEDs)對卒中后癲癇(PSE)患者血清同型半胱氨酸(Hcy)、葉酸、維生素B_(12)、維生素B_6水平的影響。方法對規(guī)則口服AEDs 1年以上的194例PSE患者(AEDs治療組)及新診斷未服藥的40例PSE患者(對照組)進(jìn)行血清Hcy、葉酸、維生素B_(12)、維生素B_6水平檢測。探討不同AEDs對患者上述指標(biāo)的影響。結(jié)果與對照組相比,AEDs治療組血清Hcy水平明顯增高,血清葉酸、維生素B_(12)水平明顯降低(均P0.05)。各組間血清維生素B_6水平的差異無統(tǒng)計學(xué)意義。與單藥治療亞組比較,聯(lián)合用藥亞組血清Hcy水平明顯升高(P0.05)。與對照組相比,采用丙戊酸鈉(VPA)、卡馬西平(CBZ)、奧卡西平(OXC)單藥治療的患者血清Hcy水平顯著增加,采用VPA、CBZ單藥治療的患者血清葉酸水平明顯降低,采用VPA單藥治療的患者血清維生素B_(12)水平明顯降低(均P0.05)。與對照組相比,采用VPA+CBZ、VPA+左乙拉西坦(LEV)、VPA+OXC、CBZ+LEV雙藥聯(lián)合治療及≥3種AEDs聯(lián)合治療的患者血清Hcy水平顯著增加,采用VPA+LEV、VPA+OXC、CBZ+LEV雙藥聯(lián)合治療及≥3種AEDs聯(lián)合治療的患者血清葉酸水平明顯降低,采用VPA+CBZ、VPA+OXC、CBZ+LEV雙藥聯(lián)合治療及≥3種AEDs聯(lián)合治療的患者血清維生素B_(12)水平明顯降低(均P0.05)。AEDs治療組高Hcy血癥(HHcy)發(fā)生率(36.6%)明顯高于對照組(20.0%)(χ~2=4.085,P=0.043)。其中聯(lián)合用藥亞組HHcy發(fā)生率(47.6%)與對照組比較差異有統(tǒng)計學(xué)意義(χ~2=6.950,P=0.008);單藥治療亞組HHcy發(fā)生率(33.6%)與對照組比較差異無統(tǒng)計學(xué)意義。VPA、CBZ單藥治療的患者HHcy發(fā)生率(40.5%;43.8%)明顯高于對照組(χ~2=3.871,P=0.049;χ~2=4.726,P=0.030)。OXC、LEV單藥治療的患者HHcy發(fā)生率(29.2%;22.9%)與對照組比較差異無統(tǒng)計學(xué)意義。結(jié)論AEDs治療對PSE患者血清維生素B_6水平的影響不大,但對其血清Hcy、葉酸、維生素B_(12)水平影響較大。聯(lián)合應(yīng)用AEDs或VPA、CBZ單藥治療可能增加PSE患者HHcy的發(fā)生率。
[Abstract]:Objective to investigate the effects of four common antiepileptic drugs (AEDs) on serum homocysteine (Hcy) and folic acid (folic acid) in patients with post-stroke epilepsy (PSEs). Methods Serum Hcyand folic acid were given to 194 patients with AEDs who had been treated regularly for more than one year with PSE and 40 newly diagnosed patients with PSE (control group). The effects of different AEDs on the above indexes were investigated. Results compared with the control group, the serum Hcy level and serum folic acid were significantly increased in the AEDs treatment group. There was no significant difference in serum vitamin B6 levels between the two groups. Compared with the single drug treatment subgroup, the serum Hcy level in the combined treatment subgroup was significantly higher than that in the control group. The serum Hcy level of the patients treated with sodium valproate, carbamazepine and oxacillin was significantly increased, while the serum folic acid level of the patients treated with VPA-CBZ was significantly decreased. The serum vitamin B level of patients treated with VPA was significantly lower than that of control group (all P 0.05). Compared with the control group, the serum Hcy level of patients treated with VPA CBZG / VPA-VPA-levoxetanolacetanolacetanolactam / VPA / VPA-OXCZ / CBZ / LEV or more than 3 kinds of AEDs was significantly higher than that of the control group (P < 0. 05, P < 0. 05). The serum folic acid level was significantly decreased in patients treated with VPA Levo VPA oxCX LEV combined with two drugs or more than 3 kinds of AEDs. The serum vitamin B level of patients treated with VPA CBZ + VPA oxCX CBZ LEV or more than 3 kinds of AEDs was significantly lower than that of the control group (P 0.05 + .AEDs treatment group), and the incidence of hyper#en3# Hcy was significantly higher than that of the control group (蠂 24.085% P0.043 3). HHcy was found in the combined subgroup (P < 0.05), especially in the control group (P < 0.05. 05%, P < 0.05), and the incidence of HHcy in the treatment group was significantly higher than that in the control group (蠂 2 4.08 5%, P < 0.043 3). There was no significant difference in the incidence of HHcy between the control group and the control group (蠂 26.950 P0. 008; the incidence of HHcy in the single drug subgroup was 33. 6). There was no significant difference in the incidence of HHcy between the two groups. The incidence of HHcy in the single drug treated group was significantly higher than that in the control group (蠂 2. 871 P0. 049; 蠂 2 + 24. 726 P0. 030. 0. 030% OXCLEV monotherapy). The incidence of HHcy in the control group was significantly higher than that in the control group (蠂 2. 871, P 0.049; 蠂 2, 24. 726, P 0.030, P 0. 030, P 0. 030, P 0. 030). There was no significant difference between the incidence of HHcy and the control group. Conclusion the effect of AEDs treatment on serum vitamin B6 level in PSE patients was not significant. However, the serum levels of Hcy, folic acid and vitamin B were significantly affected. Combined use of AEDs or VPA CBZ alone may increase the incidence of HHcy in patients with PSE.
【作者單位】： 蘇州大學(xué)附屬第二醫(yī)院神經(jīng)內(nèi)科;
【基金】：蘇州市科技發(fā)展計劃(應(yīng)用基礎(chǔ))(SYS201549)
【分類號】：R742.1;R743.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 武玉秀;;腦梗死患者B族維生素干預(yù)對高同型半胱氨酸血癥的作用[J];吉林醫(yī)學(xué);2013年23期

2 祖衡兵;鄔軍峰;趙永飛;劉愛民;;腦卒中患者高同型半胱氨酸血癥B族維生素聯(lián)合治療的隨機(jī)對照研究[J];中國臨床醫(yī)學(xué);2006年04期

3 相春霞;鄧婉秋;杜迎;;葉酸和B族維生素對急性腦梗死患者高同型半胱氨酸血癥的研究[J];北京醫(yī)學(xué);2009年07期

4 陳尚武;;聯(lián)合應(yīng)用B族維生素對腦梗死患者高同型半胱氨酸血癥的作用[J];右江民族醫(yī)學(xué)院學(xué)報;2014年01期

5 詹建梅;林海燕;王進(jìn)華;;不同劑量B族維生素對高同型半胱氨酸血癥腦梗死患者的二級預(yù)防作用[J];中華全科醫(yī)學(xué);2014年06期

6 劉愛民;徐堅;陳玉清;;B族維生素降低腦卒中患者血漿同型半胱氨酸[J];中國臨床醫(yī)學(xué);2006年04期

7 王少蘭;喬海平;趙玉紅;張月蘭;;葉酸、B族維生素對高同型半胱氨酸血癥腦梗死患者血管內(nèi)皮細(xì)胞功能的影響[J];山東醫(yī)藥;2008年27期

8 鄭竹成;;高同型半胱氨酸血癥腦梗死患者應(yīng)用葉酸和B族維生素研究[J];中外醫(yī)學(xué)研究;2011年30期

9 孟祥遠(yuǎn);類固醇加B族維生素莖乳孔注射治療Bell麻痹[J];耳鼻咽喉頭頸外科;1999年06期

10 高娟;孫雅菲;李永樂;張敬國;蘇立凱;張杏紅;郭力;;葉酸、B族維生素對青年腦卒中高同型半胱氨酸血癥的干預(yù)作用[J];腦與神經(jīng)疾病雜志;2008年04期

相關(guān)會議論文 前2條

1 張哲成;朱炬;張靜;王素紅;崔磊;田麗;;B族維生素對缺血性卒中干預(yù)的研究[A];中華醫(yī)學(xué)會第十三次全國神經(jīng)病學(xué)學(xué)術(shù)會議論文匯編[C];2010年

2 崔磊;張哲成;田麗;朱炬;劉懷翔;;Hhcy及B族維生素干預(yù)對大鼠腦血管ICAM-1表達(dá)的影響研究[A];第十一屆全國神經(jīng)病學(xué)學(xué)術(shù)會議論文匯編[C];2008年

相關(guān)碩士學(xué)位論文 前1條

1 金鳳艷;B族維生素對卒中后抑郁干預(yù)作用的臨床研究[D];天津醫(yī)科大學(xué);2011年

，

本文編號：1607659