左乙拉西坦添加治疗老年癫痫患者的临床观察

摘要

OBJECTIVE:To investigate clinical efficacy and safety of levetiracetam add-on therapy in the treatment of elderly epileptic patients. METHODS:Totally 88 elderly epileptic patients in Chongqing Yunyang County Hospital of TCM during Jan. 2014-Jan. 2016 were divided into observation group and control group according to random number table,with 44 cases in each group. Control group was given routine antiepileptic therapy of carbamazepine+phenobarbital;observation group was additionally given Levetiracetam tablet with initial dose of 0.25g,increasing to 0.5 g according to disease condition,bid,on the basis of con-trol group. Treatment courses of 2 groups lasted for 6 months. Clinical efficacies,GCS score,Barthel index score,MoCA score and the occurrence of ADR were observed in 2 groups. RESULTS:Total response rate,control rate and MoCA score of observation group were significantly higher than those of control group,with statistical significance(P<0.05). GCS and Barthel index score of 2 group after treatment were significantly higher than before treatment,and those 2 scores of observation group were significantly higher than those of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLU-SIONS:Levetiracetam add-on therapy is better than routine therapy plan in the treatment of elderly epilepsy,and significantly re-duce coma degree,increase daily living ability and cognitive function with good safety.%目的:考察左乙拉西坦添加治疗老年癫痫患者的临床效果及安全性.方法:将2014年1月-2016年1月于重庆市云阳县中医院就诊的老年癫痫患者88例按照随机数字表法分为观察组与对照组,各44例.对照组患者给予卡马西平+苯巴比妥常规抗癫痫治疗;观察组患者在对照组基础上加用左乙拉西坦片,初始剂量0.25 g,后期根据患者病情可增至0.5 g,bid.两组疗程均为6个月.观察两组患者的临床疗效、格拉斯哥昏迷评分法(GCS)评分、巴塞尔(Barthel)指数评分、蒙特利尔认知评估量表(MoCA)评分和不良反应发生情况.结果:观察组患者的总有效率、控制率和MoCA评分均显著高于对照组,差异均有统计学意义(P<0.05).两组患者治疗后的GCS和Barthel指数评分均明显高于治疗前,且观察组患者的2项评分均明显高于对照组,差异均有统计学意义(P<0.05).两组患者均未见明显不良反应发生.结论:采用左乙拉西坦添加治疗老年癫痫的疗效优于常规治疗方案,使患者的昏迷程度显著降低,日常生活能力与认知功能显著提高,且安全性较好.