奥拉西坦联合丙戊酸镁对老年脑卒中后癫痫的治疗效果及氧化应激反应的作用研究

Therapeutic effect of oxiracetam combined with valproate magnesium on senile epilepsy after stroke and analysis of oxidative stress response

摘要:

目的 探究奥拉西坦联合丙戊酸镁对老年脑卒中后癫痫的治疗效果及氧化应激反应的作用。方法 选取2021年8月—2022年9月黑龙江中医药大学附属第一医院收治的92例老年脑卒中后癫痫患者，随机分为研究组与对照组，每组46例。对照组口服丙戊酸镁缓释片治疗，研究组在对照组基础联合奥拉西坦治疗，维持治疗3个月。比较两组患者治疗前后癫痫发作频率、单次癫痫发作持续时间、日常活动能力、认知水平、氧化应激反应、药物毒性及随访6个月的复发结局。结果 治疗前后研究组癫痫发作频率差值、单次癫痫发作持续时间差值、日常活动能力评分差值、韦氏智力量表中国修订版评分差值、血清超氧化物歧化酶差值、血清脂质过氧化物差值均高于对照组（P <0.05）。两组患者不良反应发生率比较，差异无统计学意义（P >0.05）。研究组6个月的复发率低于对照组（P <0.05）。结论 奥拉西坦联合丙戊酸镁治疗老年脑卒中后癫痫，有助于提升抗癫痫效果，改善患者认知功能，减轻氧化应激损伤，且安全性良好。

Abstract:

Objective To explore the therapeutic effect of oxcarbazepine combined with magnesium valproate on post-stroke epilepsy in the elderly and its impact on oxidative stress.Methods A total of 92 elderly patients with post-stroke epilepsy admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from August 2021 to September 2022 were randomly divided into a study group and a control group, with 46 patients in each group. The control group was treated with oral sustained-release magnesium valproate, while the study group received oxcarbazepine in addition to the treatment in the control group. The treatment was maintained for 3 months. The frequency of seizures, duration of individual seizures, daily activity ability, cognitive level, oxidative stress response, drug toxicity, and recurrence outcomes were compared between the two groups before and after treatment and at a 6-month follow-up.Results The differences in seizure frequency, duration of individual seizures, daily activity ability scores, Chinese Revised Wechsler Intelligence Scale scores, serum superoxide dismutase, and serum lipid peroxide between the two groups before and after treatment were higher in the study group than in the control group (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). The recurrence rate in the study group at 6 months was lower than that in the control group (P < 0.05).Conclusion Oxcarbazepine combined with magnesium valproate in the treatment of post-stroke epilepsy in the elderly helps improve the anti-epileptic effect, enhance cognitive function, alleviate oxidative stress damage, and is safe.