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奥卡西平联合左乙拉西坦治疗成人颞叶癫痫患者认知功能障碍

的疗效观察 Δ

李欣潞 ，许 虹 ，梁 稀（昆明医科大学第一附属医院神经内科，昆明 650032）
＊
#
中图分类号 R741 文献标志码 A 文章编号 1001-0408（2020）13-1628-05
DOI 10.6039/j.issn.1001-0408.2020.13.16

摘 要 目的：观察奥卡西平联合左乙拉西坦治疗成人颞叶癫痫患者认知功能障碍的疗效。方法：根据设定的纳入与排除标准，
收集2018年1月－2019年10月在昆明医科大学第一附属医院神经内科诊治的成人颞叶癫痫患者83例，按随机数字表法分为对
照组（n＝39例）和观察组（n＝44）。对照组患者给予奥卡西平片，初始剂量为8～10 mg/（kg·d），分早、晚两次口服，然后根据患者
具体情况每周增加5～10 mg/（kg·d），最大剂量不超过45 mg/（kg·d），以最低有效治疗剂量持续治疗3个月；观察组患者在对照组
基础上加用左乙拉西坦片，起始治疗剂量为 5～10 mg/（kg·d），分早、晚两次口服，根据患者的病情严重程度每周增加 5～10
mg/（kg·d），但总剂量不超过2 000 mg/d，以最低有效治疗剂量持续治疗3个月。测定两组患者治疗前后的Pz位点事件相关电位
P300（包括 N1、P2、N2、P3 波的潜伏期和 P3 波的波幅），进行韦氏成人智力量表[WAIS-RC，包括分析语言智商（VIQ）、操作智商
（PIQ）、总智商（FIQ）评分]和临床记忆量表[CMS，转化为记忆商（MQ）分值]测试，并记录不良反应发生情况。结果：对照组患者有
5 例脱落，观察组有 7 例脱落，共有 71 例（对照组 34 例、观察组 37 例）完成研究。治疗前，两组患者的 Pz 位点 P300、WAIS-RC 和
CMS各项指标和评分差异均无统计学意义（P＞0.05）。与治疗前比较，两组患者治疗后N2、P3波潜伏期均显著缩短、P3波波幅均
显著升高（P＜0.05），VIQ、FIQ 以及 MQ 评分均显著升高（P＜0.05），并且观察组患者 P2 波潜伏期显著缩短、PIQ 评分显著升高
（P＜0.05）。与对照组比较，观察组患者治疗后P2、P3波潜伏期的缩短程度、P3波波幅的升高程度以及VIQ、PIQ、FIQ、MQ评分的
升高程度均显著增大（P＜0.05）。对照组出现 1 例轻微皮疹、1 例自感乏力，观察组出现 1 例恶心想吐、1 例自感乏力、1 例情绪不
稳，但均未见严重不良反应发生。结论：奥卡西平联合左乙拉西坦可改善成人颞叶癫痫患者的认知功能障碍，且治疗效果明显优
于奥卡西平单用。
关键词 奥卡西平；左乙拉西坦；颞叶癫痫；认知功能障碍；成人

Observation of Therapeutic Efficacy of Oxcarbazepine Combined with Levetiracetam in the Treatment of
Cognitive Dysfunction in Adult Patients with Temporal Lobe Epilepsy
LI Xinlu，XU Hong，LIANG Xi（Dept. of Neurology， the First Affiliated Hospital of Kunming Medical
University，Kunming 650032，China）

ABSTRACT OBJECTIVE：To observe therapuetic efficacy of oxcarbazepine combined with levetiracetam in the treatment of
cognitive dysfunction in adult patients with temporal lobe epilepsy. METHODS：According to inclusion and exclusion criteria，83
adult patients with temporal lobe epilepsy were collected from neurology department of the First Affiliated Hospital of Kunming
Medical University during January 2018 to October 2019，and then divided into control group（39 cases）and observation group
（44 cases）. Control group was given Oxcarbazepine tablet with initial dose of 8-10 mg/（kg·d），morning and night，increased by
5-10 mg/（kg·d）each week according to patient’s condition，the maximal dose was 45 mg/（kg·d），lasting for 3 months with the
lowest effective treatment dose. Based on treatment of control group，observation group was additionally given Levetiracetam tablet
with initial dose of 5-10 mg/（kg·d），morning and night，increased by 5-10 mg/（kg·d）each week according to the severity of
disease，the total dose was not more than 2 000 mg/d，lasting for 3 months with the lowest effective treatment dose. The
event-related potential P300 at Pz site in 2 groups was measured before and after treatment（including the incubation period of N1，
P2，N2 and P3 waves，amplitude of P3 wave）. Webster’s Adult Intelligence Scale [WAIS-RC，including verbal IQ （VIQ），
performance IQ（PIQ），full scale IQ（FIQ）scores] and Clinical Memory Scale [CMS，converting to memory quotient（MQ）
score] were adopted. The occurrence of ADR was recorded. RESULTS：Totally 5 patients of control group and 7 patients of
observation group fell off. Finally，a total of 71 patients participated in the entire study（34 cases in control group and 37 cases in
observation group）. Before treatment，there was no statistical significance in P300 at Pz site，WAIS-RC and CMS between 2
groups （P＞0.05）. Compared with before treatment，
Δ 基金项目：云南省科技计划项目[No.2017FE467（-035）]
incubation period of N2 and P3 waves was shortened
＊硕士研究生。研究方向：癫痫及神经电生理。电话：0871-
significantly in 2 groups， and amplitude of P3 wave was
65324888。E-mail：491783491@qq.com
# 通信作者：主任医师，博士。研究方向：癫痫及神经电生理。电 increased significantly after treatment （P＜0.05）；VIQ，FIQ
话：0871-65324888。E-mail：3053419674@qq.com and MQ scores were increased significantly （P＜0.05）. The

·1628 · China Pharmacy 2020 Vol. 31 No. 13 中国药房 2020年第31卷第13期