托吡酯对癫痫患者脑电活动改善及糖代谢的影响

摘要

目的：观察托吡酯对癫痫患者脑电活动改善及糖代谢的影响。方法2011年3月-2013年9月诊治的癫痫患者90例，随机分为观察组和对照组各45例，分别给予托吡酯和丙戊酸钠治疗，疗程6个月，疗程结束后检测2组患者脑电活动和糖代谢情况。结果治疗后观察组癫痫样放电数目为（9殚．56±1．03）次/20 min，α、β、δ、θ波数目分别为（21．15±3．1）次/30s、（21．92±3．95）次/30s、（13．45±2．83）次/30s、（10．92±2．13）次/30s，对照组分别为（14．50±2．50）次/20 min、（27．40±3．70）次/30s、（16．42±2．72）次/30s、（28．50±4．64）次/30s、（19．70±3．75）次/30 s，2组比较差异均有统计学意义（ P ＜0．05）。观察组血糖水平（4．32±0．52）mmol/L、体质量指数（21．34±3．22） kg/m2低于对照组[分别为（5．56±0．74）mmol/L、（24．78±3．21） kg/m2]，血胰岛素（9．94±1．42） mU/L高于对照组（8．16±1．12）mU/L，差异有统计学意义（ P均＜0．05），而IR与对照组无差异（ P ＞0．05）。结论托吡酯能更为有效地控制脑电活动，但也会导致糖代谢异常，引起血糖水平降低、血胰岛素水平升高，体质量指数下降。%Objective To study the effects of topiramate on the improvement of brain electrical activity and glucose metabolism in patients with epilepsy .Methods From March 2011 to September 2013 , 90 cases that were diagnosed and trea-ted as epilepsy were randomly divided into observation group and control group with 45 cases in each group , observation group were treated with topiramate and control group treated with valproate , treatment for 6 months.After treatment, two group pa-tients'EEG activity and glucose metabolism were detected .Results After treatment , observation group's number of epilepti-form discharges was (9.56 ±1.03) times/20 min, α, β, δ ,θ wave number was (21.15 ±3.1) times/30s, (21.92 ± 3.95) times/30s, (13.45 ±2.83) times/30s,(10.92 ±2.13) times/30s;in the control group were (14.50 ±2.50) times/20 min, (27.40 ±3.70) times/30s, (16.42 ±2.72) times/30s, (28.50 ±4.64) times/30s, (19.70 ±3.75) times/30s, the differences of 2 groups were statistically significant ( P <0.05).Observed blood glucose levels was (4.32 ±0.52) mmol/L, body mass index was (21.34 ±3.22) kg/m2,lower than the control group [(5.56 ±0.74) mmol/L, (24.78 ± 3.21) kg/m2], serum insulin was (9.94 ±1.42) mU/L in observation group, higher than control group (8.16 ±1.12) mU/L, the difference was statistically significant ( P <0.05),whereas no difference of IR compared with the control group (P >0.05).Conclusion Topiramate can effectively control the electrical activity of brain , but could also lead to abnormal glucose metabolism , including elevated blood glucose levels and decreased blood insulin levels .