摘要
目的分析丙戊酸钠联合拉莫三嗪治疗难治性癫痫患者的临床疗效。方法选取2020年1月至2021年11月济宁市兖州区人民医院收治的86例难治性癫痫患者作为研究对象,按照随机数字表法分为参比组与分析组,每组43例。参比组给予丙戊酸钠单药治疗,分析组在参比组基础上加用拉莫三嗪治疗。比较两组临床疗效、神经细胞营养状态[神经生长因子(nerve growth factor,NGF)、神经营养因子(brainn derived neurotrophic factor,BDNF)]、神经细胞凋亡状态[凋亡相关因子配体(factor-related apoptosis ligand,FasL)、Fas受体(Fas receptor,sFas)、B细胞淋巴瘤-2(B-cell lymphoma-2,Bcl-2)及Bcl-2关联X蛋白(Bcl-2-associated X protein,BAX)]水平、炎症因子[白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1β,IL-1β)、前列腺素E2(prostaglandin E2,PGE2)]水平及不良反应发生情况。结果分析组治疗总有效率为95.35%,高于参比组的76.74%,差异有统计学意义(P<0.05);治疗后,分析组血清NGF、BDNF水平均高于参比组,差异有统计学意义(P<0.05);治疗后,分析组血清FasL、sFas、Bcl-2水平均低于参比组,BAX水平高于参比组,差异有统计学意义(P<0.05);分析组IL-6、IL-1β、PGE2水平均低于参比组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉莫三嗪联合丙戊酸钠治疗难治性癫痫疗效显著,可改善患者神经细胞营养状态,减轻炎症反应,控制神经细胞的凋亡,值得临床推广应用。
Objective To analyze the clinical efficacy of sodium valproate combined with lamotrigine for patients with refractory epilepsy.Methods 86 patients with intractable epilepsy addmitted to Yanzhou District People's Hospital of Jining from January 2020 to November 2021 were selected as the study subjects,and they were divided into the reference group and the analysis group,with 43 cases in each group.The reference group was given sodium valproate monotherapy,the analysis group was treated with lamotrigine added to the reference group.The clinical efficacy,nerve cell trophic state(nerve growth factor[NGF],brainn derived neurotrophic factor[BDNF]),apoptosis status of nerve cells(factor-related apoptosis ligand[FasL],Fas receptor[sFas],B-cell lymphoma-2[Bcl-2],Bcl-2 associated X protein[BAX]),inflammatory factors(interleukin-6[IL-6],interleukin-1β[IL-1β],prostaglandin E2[PGE2])levels and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the analysis group was 95.35%,which was higher than 76.74%in the reference group,and the difference was statistically significant(P<0.05);after treatment,the levels of serum NGF and BDNF in the analysis group were higher than those in the reference group,and the differences were statistically significant(P<0.05);after treatment,the levels of serum FasL,sFas and Bcl-2 in the analysis group were lower than those in the reference group,while the level of BAX in the analysis group was higher than that in the reference group,and the differences were statistically significant(P<0.05);the levels of IL-6,IL-1βand PGE2 in the analysis group were lower than those in the reference group,and the differencse were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Lamotrigine combined with valproate is effective in the treatment of refractory epilepsy,it can improve the nutritional status of nerve cells,reduce inflammation,control the apoptosis of nerve cells,which is worthy of clinical promotion and application.
作者
杨雪华
王朝娜
王利
YANG Xuehua;WANG Chaona;WANG Li(Department of Internal Medicine,Yanzhou District People's Hospital of Jining,Jining,Shandong,272100,China)
出处
《当代医学》
2024年第36期21-24,共4页
Contemporary Medicine
关键词
丙戊酸钠
难治性癫痫
拉莫三嗪
神经细胞
营养
凋亡
炎症
Sodium valproate
Intractable epilepsy
Lamotrigine
Nerve cell
Nutrition
Apoptosis
Inflammation
