摘要
目的评估左乙拉西坦(LEV)对成人急性颅脑外伤患者晚期癫痫发作(LPTE)的发生率及认知功能变化的影响。方法选取山西医科大学第一医院神经外科和急诊科2013年5至12月住院的成人颅脑外伤患者95例,并将其随机分为三组:A组,30例患者给予口服LEV,500 mg/次,2次/d;B组,32例患者给予口服丙戊酸缓释片,500 mg/次,1次/d;C组,33例作为对照组,未服抗癫痫药物。观察三组患者随访一年的癫痫发生率与脑电图情况,使用简易智力状况检查法(MMSE)量表评价患者的认知情况。结果三组患者一年内LPTE累计发生率分别为3.33%、12.50%、15.63%。A组LPTE的发生率低于B组和C组,差异有统计学意义(PA-B=0.031,PA-C=0.017),B组LPTE的发生率低于C组,但差异无统计学意义(P>0.05)。A组患者用药前后的脑电图有差别,差异有统计学意义(P=0.025),B组和C组患者用药前后的脑电图差异无统计学意义(均P>0.05)。A组用药前后MMSE量表评分改善程度和B组、C组比较,差异无统计学意义(均P>0.05)。结论 LEV具有较好的预防外伤后癫痫发生的作用,且可以改善患者的脑电图情况。
Objective To evaluate the effect of levetiracetam （LEV） on preventing late postttraumatic epilepsy（LTPE）and cognitive changes in patients with brain injury. Methods 95 cases of traumatic brain injury patients from May, 2013 to December, 2013 in Neurosurgery and Emergency Department of the First Hospital of Shanxi Medical University were selected and divided into three groups randomly. Group A received levetiracetam（ 500 nag at a time, bid）, and group B received sodium valproate （500 mg at a time,qd）. 33 cases were as control group（ group C）. The incidence of epilepsy,improvement of electroencephalogram（EEG） and simple intelligence test [ mini-getting the state examination（MMSE） ] were compared after a year. Results Of the 95 cases,LPTE 12-mouth cumulative incidence of three groups was 3. 33% ,12. 50%, 15. 63% ,there were statistical differences between group A and group B, group A and group C （PA-B = 0. 031,PA-C = 0. 017 ）. There was no significant difference between group B and group C （P 〉 0. 05）. The EEG after treatment in group A had been improved, there was no improvement between group B and group C （ all P 〉 0. 05 ）. There was no statistical difference in initial MMSE score among three groups （ all P 〉 0. 05）. Conclusion LEV plays a good role to prevent posttraumatic epilepsy, and can partially improve the EEG conditions in patients with brain injury.
出处
《中华脑科疾病与康复杂志（电子版）》
2015年第5期9-12,共4页
Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）
关键词
癫痫
创伤后
脑电描记术
左乙拉西坦
简易智能检查
Epilepsy, post-traumatic
Electroencephalogram
Levetiracetam
Mini-mental state examination
