【摘要】：目的比較左乙拉西坦、拉莫三嗪治療丙戊酸無(wú)效型成人難治性癲癇部分性發(fā)作的臨床效果。方法選取丙戊酸無(wú)效型成人難治性癲癇部分性發(fā)作患者120例,隨機(jī)分為左乙拉西坦組55例與拉莫三嗪組65例。兩組均維持原有丙戊酸治療方案,左乙拉西坦組加用左乙拉西坦、拉莫三嗪組加用拉莫三嗪,均連續(xù)治療6個(gè)月。比較兩組治療效果;治療前后進(jìn)行腦電圖檢查,計(jì)數(shù)20 min內(nèi)清醒期腦電圖癇樣放電(IEA)次數(shù),統(tǒng)計(jì)與治療前比較IEA消失、減少≥50%、減少50%、無(wú)變化、增加的患者比例,計(jì)算α節(jié)律及δ、θ、α、β各頻段功率;統(tǒng)計(jì)持續(xù)用藥3、6個(gè)月用藥保留率;記錄兩組用藥期間不良反應(yīng)發(fā)生率。結(jié)果拉莫三嗪組總有效率80.00%(52/65),左乙拉西坦組為69.09%(38/55),兩組比較P0.05。持續(xù)用藥6個(gè)月結(jié)束時(shí),兩組IEA消失、減少≥50%、減少50%的患者比例比較P均0.05;拉莫三嗪組IEA無(wú)變化及增加的患者比例均大于左乙拉西坦組(P均0.05)。兩組治療前后α節(jié)律及δ、θ、α、β頻段功率均無(wú)明顯變化,組間及組內(nèi)比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。左乙拉西坦組、拉莫三嗪組用藥3個(gè)月時(shí)用藥保留率均為100%;用藥6個(gè)月時(shí)分別為60.00%(33/55)、76.92%(50/65),組間比較P0.05。治療期間,左乙拉西坦組不良反應(yīng)以嗜睡多見,拉莫三嗪組以皮疹多見,但兩組各不良反應(yīng)發(fā)生率比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論左乙拉西坦與拉莫三嗪對(duì)丙戊酸無(wú)效型難治性癲癇部分性發(fā)作的治療效果相當(dāng)。
[Abstract]:Objective to compare the clinical effects of levoethoxetam and lamotrigine in the treatment of refractory partial seizures in adults with valproic acid ineffectiveness. Methods one hundred and twenty patients with partial seizure of refractory epilepsy with valproic acid ineffectual type were randomly divided into levoethylacetam group (55 cases) and lamotriazine group (65 cases). The original valproic acid regimen was maintained in both groups. The levoethoxetam group and lamotrigine group were treated with levoethylacetam and lamotrigine for 6 months. The therapeutic effects were compared between the two groups. EEG examination was performed before and after treatment, and the number of epileptiform discharges of epileptiform discharge in awake period within 20 min was counted. Compared with before and after treatment, IEA disappeared, decreased 鈮，

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