奥卡西平和丙戊酸钠对成人部分性癫痫患者脑电图及相关血液学指标水平的影响

摘要

目的 研究奥卡西平和丙戊酸钠对成人部分性癫痫患者脑电图及外周血同型半胱氨酸(Hcy)和不对称二甲基精氨酸(ADMA)水平的影响.方法 于2014年5月至2015年5月,将100例成人部分性癫痫患者随机分为治疗组(奥卡西平治疗)和对照组(丙戊酸钠治疗),每组各50例.观察治疗后患者脑电图指标、Hcy、ADMA、认知功能变化及不良反应发生情况.结果 治疗前,两组患者脑电图指标检查结果比较差异无统计学意义(P>0.05);治疗后,两组患者α波减少超过0.5 Hz、θ波增多、δ波增多发生率比较差异有统计学意义(P<0.05).治疗前,两组患者血清Hcy、ADMA水平比较差异无统计学意义(P>0.05);治疗后,两组患者血清Hcy、ADMA水平均显著升高(P<0.05).治疗前,两组患者简明精神状态检查量表(MMSE)评分比较差异无统计学意义(P>0.05);治疗后,治疗组患者MMSE评分高于对照组(P<0.05).治疗组患者中,出现皮疹1例、胃肠道不适2例,均自行好转;对照组患者中,出现眩晕3例、皮疹5例、胃肠道不适1例,均自行好转.结论 奥卡西平与丙戊酸钠对外周血Hcy、ADMA水平的影响类似;与丙戊酸钠相比,奥卡西平可显著改善癫痫患者认知功能.%Objective To investigate the effect of oxcarbazepine(OXC) and sodium valproate(VPA) on electroencephalogram(EEG) and peripheral blood levels of homocysteine(Hcy) and asymmetric dimethylarginine(ADMA) in adult patients with partial epilepsy.Methods From May.2014 to May.2015,a total of 100 patients with partial epilepsy were enrolled and randomly divided into treatment group(treated with OXC) and control group(treated with VPA),with 50 cases in each group.After treatment,changes of EEG indices,Hcy,ADMA,cognitive function and adverse reaction were analyzed.Results Before treatment,there was no significant difference of EEG indices between the two groups(P>0.05).After treatment,the incidence rates of α wave decreasing more than 0.5 Hz,increasing of θ wave and increasing of δ wave were significantly different(P< 0.05).Before treatment,there was no significant difference of serum Hcy and ADMA levels between the two groups(P>0.05).After treatment,serum Hcy and ADMA levels were both significantly increased(P<0.05).Before treatment,Mini-mental State Examination(MMSE) scores of the two groups were without significant difference(P>0.05).After treatment,MMSE score of treatment group was higher than that of control group(P<0.05).In treatment group,there were 1 case of skin rash and 2 cases of gastrointestinal discomfort,which were self-improved.In control group,there were 3 cases of dizziness,5 cases of skin rash and 1 case of gastrointestinal discomfort,which were self-improved.Conclusion The effects of OXC and VAP on peripheral blood levels of Hcy and ADMA could be similar,and compared with VAP,OXC could significantly improve cognitive function in patients with epilepsy.