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目的:新型抗癫痫药左乙拉西坦、托吡酯单药治疗癫痫部分性发作临床疗效研究及对认知功能的影响。方法:将90例癫痫部分性发作的患者先采用蒙特利尔认知评估量表(MOCA)进行认知功能的评估,然后采用随机、双盲的方法,分成3组:A组:左乙拉西坦治疗组30例:B组:托吡酯治疗组30例:C组:卡马西平对照组30例:观察用药24周后各组间临床癫痫控制率、脑电图的改善、不良反应及MOCA的评分变化。结果:1临床疗效:3组临床疗效相比较无统计学意义(P>0.05),但癫痫完全控制无发作率B组明显低于A组及对照组,有统计学意义(P<0.05);2脑电图的改善:脑电控制率B组明显低于A组及C组(P<0.05);3认知功能的影响:癫痫后认知功能障碍的发生率为35.6%。A组MOCA评分与B组比较,提高有显著差异(P<0.05);4不良反应:A组与B组相比,不良反应发生率低(P<0.05)。结论:癫痫后认知功能障碍的发生率较高。新型抗癫痫药物左乙拉西坦、托吡酯在控制癫痫部分性发作方面均有较好疗效,但是不良反应发生率托吡酯较左乙拉西坦高;在改善认知功能方面,托吡酯疗效不如左乙拉西坦。
OBJECTIVE: To study the clinical efficacy of a novel antiepileptic drug, levetiracetam and topiramate, in the treatment of partial epilepsy and its effect on cognitive function. Methods: Ninety patients with partial epilepsy were assessed with cognitive function using the Montreal Cognitive Assessment Scale (MOCA) and then divided into three groups using a randomized, double-blind approach: Group A: levetiracetam 30 cases in treatment group: Group B: 30 cases in topiramate treatment group: 30 cases in group C: carbamazepine control group: Clinical epilepsy control rate, EEG improvement, adverse reactions and MOCA score Variety. Results: 1 The clinical curative effect: There was no significant difference in clinical curative effect between the three groups (P> 0.05), but there was no significant difference between the two groups (P <0.05). 2 EEG improvement: EEG control rate in group B was significantly lower than that in group A and group C (P <0.05); 3 The impact of cognitive function: The incidence of cognitive dysfunction after epilepsy was 35.6%. The MOCA score of group A was significantly higher than that of group B (P <0.05). 4 Adverse reactions: The incidence of adverse reactions in group A was lower than that in group B (P <0.05). Conclusion: The incidence of cognitive dysfunction after epilepsy is higher. The new anti-epileptic drugs levetiracetam, topiramate in the control of partial seizures have a good effect, but the incidence of adverse reactions topiramate ester than levetiracetam high; in improving cognitive function, topiramate less effective than the left B Racitan.