摘要
目的探讨脑脊液α-氨基羟甲基恶唑丙酸(AMPA)受体水平对拉莫三嗪治疗癫痫临床疗效的影响。方法选取2017年12月至2019年10月间我院诊治的70例癫痫患者为研究对象,采用酶联免疫吸附试验测定患者脑脊液AMPA受体含量,以其测定中位数值4.08 ng/ml为分界值,将患者配对分组为高AMPA组(34例)和低AMPA组(36例);分别比较两组患者拉莫三嗪临床治疗效果和不良反应发生情况。结果治疗前,两组患者癫痫发作次数比较无明显差异(P>0.05);治疗后6 m和12 m,两组患者癫痫的发作次数均逐渐减少(P<0.05);低AMPA组患者的癫痫发作次数明显少于高AMPA组(P<0.05);高AMPA组患者的应答率为79.41%,明显低于低AMPA组(χ^2=6.055,P=0.048);而且,高AMPA组的脑电图改善有效率为67.65%,也明显低于低AMPA组(χ^2=4.686,P=0.030);但两组患者不良反应发生率比较差异无统计学意义(χ^2=0.202,P=0.653)。结论脑脊液AMPA受体在癫痫发生发展中发挥重要作用,且低AMPA受体水平癫痫患者予以拉莫三嗪治疗效果更佳。
Objective To explore the effects of cerebrospinal fluid AMPA receptor levels on the clinical efficacy of lamotrigine in the treatment of epilepsy.Methods The 70 cases of epilepsy in our hospital were diagnosed and selected in this study from December 2017 to October 2019;The AMPA receptor content of patients in cerebrospinal fluid were determined by enzyme linked immunosorbent assay;The patients were paired into high AMPA group(n=34)and low AMPA group(n=36)according to the median value at 4.08 ng/ml.Clinical efficacy and the incidence of adverse reactions were compared between two groups.Results Before treatment,there was no significant difference in seizure frequency between the two groups(P>0.05);After treatment for 6 months and 12 months,the seizure frequencies of the two groups were gradually reduced(P<0.05);Moreover,the number of seizures in the low AMPA group were significantly less than those in the high AMPA group(P<0.05);The response rate of high AMPA group was 79.41%,which was significantly lower than that in the low group AMPA(χ^2=6.055,P=0.048);The improvement on the efficiency of electroencephalogram in the high AMPA group was 67.65%,which was significantly lower than that in the low AMPA group(χ^2=4.686,P=0.030);However,there was no significant on the incidence of adverse reactions between two groups(χ^2=0.202,P=0.653).Conclusion AMPA receptor plays an important role in the development of epilepsy and the low AMPA receptor level patients were more efficacies to the treatment of lamotrigine.
作者
谭庆晶
刘永辉
杨俊威
王天保
林浩海
TAN Qingjing;LIU Yonghui;YANG Junwei(Department of Encephalopathy,District Two,The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)
出处
《中风与神经疾病杂志》
CAS
2020年第7期585-588,共4页
Journal of Apoplexy and Nervous Diseases
基金
国家自然科学基金地区基金项目(No.81860222)
广西中医药大学自然科学基金面上项目(No.2019MS025)。
