拉莫三嗪添加联合大脑半球环岛叶离断术治疗丙戊酸无效型癫痫患者的效果

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摘要目的观察拉莫三嗪联合大脑半球环岛叶离断术在丙戊酸无效型癫痫患者治疗中的效果。方法选取2017年1月—2018年6月在贵州省人民医院确诊并治疗的丙戊酸无效型癫痫患者为研究对象，共86例。将接受添加拉莫三嗪方式治疗的43例丙戊酸无效型癫痫患者纳入药物添加组，将接受拉莫三嗪添加联合大脑半球环岛叶离断术治疗的43例丙戊酸无效型癫痫患者纳入拉莫离断组。比较两组患者治疗有效率、韦氏儿童认知功能评测量表（WISC）评分、海马氢离子磁共振波谱成像参数及不良反应情况。结果拉莫离断组治疗有效率高于药物添加组，差异有统计学意义（P ＜ 0.05）。两组患者治疗后WISC评分高于治疗前，且拉莫离断组高于药物添加组，差异有统计学意义（P ＜ 0.05）。两组患者治疗后N-乙酰天门冬氨酸（NAA）、NAA/[胆碱（Cho）+肌酸（Cr）]高于治疗前，而Cho、Cr低于治疗前，且拉莫离断组NAA、NAA/（Cho+Cr）高于药物添加组，Cho、Cr低于药物添加组，差异有统计学意义（P ＜ 0.05）。拉莫离断组不良反应率低于药物添加组，差异有统计学意义（P ＜ 0.05）。结论拉莫三嗪添加联合大脑半球环岛叶离断术治疗丙戊酸无效型癫痫患者效果确切，不良反应较少，且在改善患者认知功能及海马组织代谢功能上效果显著。

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	李筹忠1 魏玲2 苑宝文3▲ 胡晓4

关键词 ：丙戊酸, 拉莫三嗪, 大脑半球环岛叶离断术, 癫痫, 添加, 疗效

Abstract：Objective To observe the effect of Lamotrigine combined with cerebral hemisphere ring insular lobe transection in the treatment of patients with valproic acid ineffective epilepsy. Methods A total of 86 patients with valproic acid ineffective epilepsy who were diagnosed and treated at Guizhou Provincial People’s Hospital from January 2017 to June 2018 were selected as the research objects. A total of 43 patients with valproic acid ineffective epilepsy who received Lamotrigine treatment were divided into the drug addition group, and another 43 patients with valproic acid ineffective epilepsy who received Lamotrigine addition combined with cerebral hemisphere ring lobe insula transection were divided into the Lamotrigine disconnection group. The effective rate of treatment, Wechsler intelligence scale for children (WISC) scores, hippocampal hydrogen ion magnetic resonance spectroscopy imaging parameters and adverse reactions were compared between the two groups. Results The effective rate of treatment in the Lamotrigine disconnection group was higher than that of the drug addition group, and the difference was statistically significant (P ＜ 0.05). The WISC scores of the two groups after treatment were higher than those before treatment, and the lamotrigine group was higher than that in the drug addition group, and the differences were statistically significant (P ＜ 0.05). After treatment, N-acetylaspartate acid (NAA) and NAA/(choline[Cho]+creatine[Cr]) of the two groups were higher than before treatment, while Cho and Cr were lower than before treatment, and NAA and NAA/(Cho+Cr) in the Lamotrigine dicconnection group were higher than those in the drug addition group, Cho, Cr were lower than those in the drug addition group, and the differences were statistically significant (P ＜ 0.05). The adverse reaction rate of the Lamotrigine dicconnection group was lower than that of the drug addition group, and the difference was statistically significant (P ＜ 0.05). Conclusion The addition of Lamotrigine combined with cerebral hemisphere ring insular lobe transection has a definite effect in the treatment of patients with valproic acid ineffective epilepsy, with fewer adverse reactions, and has a significant effect in improving patients’ cognitive function and hippocampal tissue metabolism.

Key words： Valproic acid Lamotrigine Hemisphere ring insular lobe transection Epilepsy Addition Efficacy

基金资助:国家自然科学基金资助项目（81401083）。

通讯作者: ▲通讯作者

引用本文:

李筹忠1 魏玲2 苑宝文3▲ 胡晓4. 拉莫三嗪添加联合大脑半球环岛叶离断术治疗丙戊酸无效型癫痫患者的效果[J]. 中国医药导报, 2020, 17(32): 60-63.
LI Chouzhong1 WEI Ling2 YUAN Baowen3▲ HU Xiao4. Effect of Lamotrigine combined with cerebral hemispheric ring insular lobe transection in patients with valproic acid ineffective epilepsy. 中国医药导报, 2020, 17(32): 60-63.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I32/60

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