醒脑静注射液联合奥卡西平对癫痫患者T淋巴细胞亚群及血清ALP ICAM-I水平变化影响

目的探讨醒脑静注射液联合奥卡西平对癫痫患者T淋巴细胞亚群及血清碱性磷酸酶(ALP)、细胞间黏附分子(ICAM-I)水平变化影响。方法选取2014-10—2016-11我院收治的86例癫痫患者,随机数字表法分为2组各43例。对照组给予奥卡西平,研究组给予醒脑静注射液+奥卡西平,2组均治疗3个月。统计2组临床疗效、T淋巴细胞亚群指标(CD3~+、CD4~+、CD8~+)与ALP、ICAM-I变化情况、不良反应发生情况。结果研究组治疗有效率(97.67%)高于对照组(74.42%),差异有统计学意义(P0.05);治疗后研究组CD3~+、CD4~+水平高于对照组,CD8~+水平低于对照组,差异有统计学意义(P0.05);治疗后研究组ICAM-I水平低于对照组,差异有统计学意义(P0.05);研究组不良反应发生率(13.95%)与对照组(18.60%)相比,差异无统计学意义(P0.05)。结论醒脑静注射液联合奥卡西平治疗癫痫患者可改善T淋巴细胞亚群、降低ICAM-I水平,且临床疗效显著,安全性较高。     

奥卡西平对特发性癫痫患儿免疫功能的影响

目的探讨奥卡西平在特发性癫痫患者治疗中对其免疫功能的影响。方法 96例特发性癫痫患儿为观察组,100例健康儿童为对照组,观察组给予奥卡西平治疗,对比观察组用药前、用药3个月、6个月后免疫功能。结果用药前观察组IgG、IgA、IgM、CD8、ICAM-I水平均显著高于对照组(P0.05),CD3、CD4显著低于对照组(P0.05);用药3个月后观察组IgG、IgA、CD8均显著低于用药前(P0.05),CD3显著高于用药前(P0.05),但与对照组比较差异无统计学意义(P0.05),服药3个月时观察组ICAM-I、CD4、IgM与服药前及对照组比较差异均无统计学意义(P0.05);用药6个月后观察组IgG、IgA、CD8、ICAM-I均显著低于用药前(P0.05),CD4显著高于用药前(P0.05),但与对照组比较差异无统计学意义(P0.05),IgM、CD3与用药前及对照组比较差异均无统计学意义(P0.05)。结论奥卡西平用于特发性癫痫患儿的治疗,不仅能够有效控制癫痫发作,同时能够提高患儿机体免疫功能,减少感染对生活质量的影响,值得临床推广。     

年龄及联合用药对癫痫患者奥卡西平血药浓度的影响

目的探讨年龄及联合用药对癫痫患者奥卡西平(OXC)血药浓度的影响。方法对110例口服OXC治疗的癫痫患者血浆中OXC活性代谢产物10,11-二氢-10-羟基卡马西平(OHC)浓度进行检测。计算患者血浆OHC浓度剂量比(CDR)=OHC浓度/(OXC剂量/体质量)。以CDR表示患者奥卡西平血药浓度进行相关分析。结果本组患者口服OXC剂量为300~1500 mg/d,平均(709.13±261.67)mg/d;血浆OHC浓度为1.03~25.38μm/ml,平均(11.64±5.73)μm/ml;CDR为0.06~2.75,平均(0.99±0.54)。相关性分析显示,患者血浆OHC浓度与OXC剂量/体质量呈正相关(r=0.461,P0.01);CDR与年龄呈正相关(r=0.548,P0.01);CDR与性别、癫痫发作类型、病程无关(均P0.05)。OXC+肝酶诱导类抗癫痫药物治疗的CDR明显低于OXC单药治疗(均P0.05)。血浆OHC浓度12μm/ml者总有效率(55%)明显低于血浆OHC浓度≥12μm/ml者(90%)(χ2=25.6,P0.01)。结论在300~1500 mg/d剂量范围内,增加OXC给药剂量可增加血浆OHC浓度,提高抗癫痫疗效。低龄、联合肝酶诱导类抗癫痫药物可降低OXC血药浓度,高龄可增高OXC血药浓度。     

奥拉西坦联合银杏达莫注射液治疗血管性痴呆临床研究

目的探讨奥拉西坦联合银杏达莫注射液治疗血管性痴呆的临床效果。方法选择我院2008-09—2010-09血管性痴呆患者80例,随机分观察组和对照组。2组患者均给予常规治疗。观察组同时给予银杏达莫注射液和奥拉西坦。采用简易智力状态量表(MMSE)、画钟试验和日常生活活动能力量表(ADL)对2组患者治疗前后进行评定。结果观察组治疗后MMSE和画钟试验评分与对照组治疗后比较,差异有统计学意义(P<0.05);观察组治疗后ADL评分与对照组治疗后比较,差异有统计学意义(P<0.05);2组总有效率比较,差异有统计学意义(P<0.05)。结论奥拉西坦联合银杏达莫注射液能够显著改善血管性痴呆患者的认知障碍,提高患者日常生活活动能力,临床效果显著。     

尿激酶联合银杏达莫注射液治疗脑血栓形成临床疗效观察

目的 探讨尿激酶联合银杏达莫注射液治疗脑血栓形成的临床效果.方法 选择我院脑血栓形成患者共82例,随机分为观察组和对照组.2组均给予常规治疗,对照组同时给予银杏达莫注射液,观察组给予尿激酶和银杏达莫注射液.观察2组治疗前后神经功能缺损情况.结果 观察组治疗后神经功能缺损评分显著低于对照组,差异有统计学意义（P〈0.05）.观察组总有效率95.1%;对照组75.6%,观察组总有效率高于对照组,差异有统计学意义（P〈0.05）.结论 尿激酶联合银杏达莫注射液能够改善脑血栓形成患者神经功能缺损症状,疗效显著,值得借鉴.     

银杏达莫联合丹参川芎嗪注射液治疗老年急性脑梗死患者的疗效及对EEG和CHE、VCAM-1水平的影响

目的研究银杏达莫联合丹参川芎嗪注射液治疗老年急性脑梗死(ACI)患者的疗效及对脑电图(EEG)和血清胆碱脂酶(CHE)、血管细胞黏附分子-1(VCAM-1)水平的影响。方法本研究对象为2015年6月至2017年6月期间本院收治的120例老年ACI患者,根据随机数字表法分为对照组和观察组,各60例,两组患者均进行常规治疗,对照组患者在超出常规治疗基础上加用银杏达莫治疗,观察组患者在对照组治疗的基础上联合使用丹参川芎嗪注射液两组患者均为7d 1疗程,持续治疗2疗程。观察两组患者治疗效果,治疗前后血清人纤维蛋白原(FIB)、C-反应蛋白(CRP)、白细胞介素6(IL-6)、CHE、VCAM-1水平、层叠样式表(CSS)评分、脑梗死体积和日常生活活动的功能状态(Barthel指数)、两组患者发生药物不良反应之间的差异。结果观察组患者治疗总有效率为81.67%,显著高于对照组的65.00%(P0.05);治疗2w后,两组患者FIB、CRP及IL-6水平均显著降低,且观察组FIB、CRP及IL-6水平低于对照组(P0.05);两组患者CSS评分和脑梗死体积显著降低,Barthel指数显著升高,观察组各指标更优于对照组(P0.05);两组患者定量EEG指标(DTABR值)检测结果均显著降低,且观察组更低于对照组(P0.05);两组患者CHE水平显著升高,VCAM-1水平显著降低,且观察组指标更优于对照组(P0.05)。两组患者不良反应之间的差异无统计学意义(P0.05)。结论银杏达莫联合丹参川芎嗪注射液治疗老年ACI临床疗效确切,能够显著改善患者神经功能,有效降低血清CHE及VCAM-1水平,安全性较高,值得临床应用。     

银杏达莫联合脉络宁注射液治疗急性脑梗死42例效果观察

目的探讨银杏达莫注射液联合脉络宁注射液治疗急性脑梗死临床疗效。方法选择我院2007-12~2009-12急性脑梗死患者82例,将以上患者随机分为2组,观察组和对照组。2组患者均根据病情情况,给予支持治疗,给予脑保护剂,控制患者血糖、血压等,有脑水肿颅内压升高患者给予脱水治疗。在以上基础上,观察组患者给予银杏达莫注射液20 mL加入生理盐水250 mL中静滴,1次/d,同时给予脉络宁注射液20 mL加入生理盐水250 mL中静滴,1次/d;对照组患者给予脉络宁注射液20 mL加入生理盐水250 mL中静滴。2组患者疗程均为14 d。结果观察组治疗后NIHSS评分与对照组治疗后评分比较,差异有统计学意义(P<0.05);2组患者治疗后,观察组总有效率与对照组总有效率比较,差异有统计学意义(P<0.05)。结论银杏达莫注射液联合脉络宁注射液能够显著改善急性脑梗死患者神经功能,临床效果显著,值得借鉴。     

低分子肝素联合银杏达莫治疗急性脑梗死的研究

目的观察低分子肝素联合银杏达莫治疗急性脑梗死的疗效。方法入选病例246例随机分成治疗组、对照组。治疗组予以低分子肝素联合银杏达莫治疗,对照组单用血栓通治疗,观察2组神经功能恢复情况。结果低分子肝素联合银杏达莫治疗总显效率96.8%,明显优于对照组的63.9%,经统计学分析差异有统计学意义(P<0.05)。结论低分子肝素联合银杏达莫治疗急性脑梗死具有肯定的临床疗效。     

银杏达莫注射液治疗急性脑梗死的疗效观察

目的 观察银杏达莫注射液治疗脑梗死的临床疗效与安全性.方法 192例住院脑梗死患者随机分成银杏达莫治疗组和对照组,治疗组给予银杏达莫注射液20 mL加生理盐水250 mL静滴,1次/d,连用14 d.对照组给予丹参注射液20 mL加生理盐水250 mL静滴,1次/d,连用14d.14 d后评定2组临床疗效和神经功能缺损...     

依达拉奉联合银杏达莫注射液治疗急性脑梗死临床观察

我们对依达拉奉联合银杏达莫注射液治疗急性脑梗死的疗效及安全性进行观察,现报告如下。1对象和方法1.1对象70例均为我科住院患者,入选标准依照《脑血管疾     

奥卡西平治疗癫癎的临床研究

目的观察奥卡西平(OXC)治疗癫癎的疗效、耐受性和安全性。方法294例患者,120例加用OXC治疗,174例单用OXC治疗。通过逐步加量的方法达到目标剂量。结果本组总有效率为86.05%,完全控制为39.8%;其中单药治疗组控制率45.98%,总有效率为89.08%,添加治疗组控制率为30.83%,总有效率为81.67%。单药治疗组不良反应总发生率为15.52%,添加组不良反应发生率为26.67%,2组比较,添加治疗组出现的反应相对多于单药治疗组。结论奥卡西平治疗癫癎有效、安全、稳定。     

奥卡西平联合神经阻滞治疗原发性三叉神经痛的临床疗效

目的：分析奥卡西平联合神经阻滞治疗原发性三叉神经痛的临床疗效。方法选择2011-02-2013-09在我院接受诊治的原发性三叉神经痛患者94例,按照随机数字表法分为对照组（n＝47）与治疗组（n＝47）。对照组给予奥卡西平治疗,治疗组在奥卡西平治疗基础上采取神经阻滞治疗。结果治疗组治疗后1 d、3周、6周NRS评分均明显低于对照组（P＜0.05）;治疗组总有效率91.49％,显著高于对照组的78.72％,差异有统计学意义（ P＜0.05）;治疗组不良反应显著低于对照组,差异有统计学意义（ P＜0.05）。结论奥卡西平联合神经阻滞治疗原发性三叉神经痛疗效显著,且不良反应较轻,具有重要临床价值。     

T细胞亚群及粘附分子在实验性变态反应性神经炎中的作用

目的探讨Ｔ细胞亚群及粘附分子在实验性变态反应性神经炎（ＥＡＮ）中的作用。方法用兔坐骨神经匀浆免疫Ｗｉｓｔａｒ大鼠，建立ＥＡＮ模型；同时用抗细胞间粘附分子－１（ＩＣＡＭ－１）单抗注入大鼠后再诱导ＥＡＮ。观察自然病程组、抗体注射组及对照组动物的临床病理。用双重酶标免疫组化技术检测ＣＤ４＋、ＣＤ８＋Ｔ细胞分布以及粘附分子ＣＤ５４、ＣＤ１１ａ、ＣＤ６２在ＣＤ４＋及ＣＤ８＋细胞上的表达。结果抗体注射组发病率及发病程度明显低于自然病程组；组织中粘附分子在ＣＤ４＋细胞上的表达及ＣＤ４＋／ＣＤ８＋自然病程组高于抗体注射组；ＣＤ５４、ＣＤ１１ａ在ＣＤ４＋细胞上的表达高于ＣＤ８＋细胞。结论ＣＤ４＋细胞是主要的效应细胞，ＣＤ４＋细胞上粘附分子的表达对效应Ｔ细胞进入病变组织起主导作用；抗ＩＣＡＭ－１抗体能够预防ＥＡＮ发生。     

The evaluation of thyroid functions, thyroid antibodies, and thyroid volumes in children with epilepsy during short-term administration of oxcarbazepine and valproate

PURPOSE: The aim of this study was to evaluate the effects of short-term oxcarbazepine (OXC) and valproate (VPA) monotherapy on thyroid functions in children. METHODS: Fifty-five newly diagnosed epileptic children with normal thyroid functions (confirmed with the thyrotropin releasing hormone stimulation test) participated in this study. VPA treatment was started in 30 patients and OXC in 25 patients. Serum thyroxine (T(4)), free thyroxine (fT(4)), triiodothyronine (T(3)), free triiodothyronine (fT(3)), reverse T3 (rT(3)), thyroid peroxidase antibodies (TPO-ab), and urine iodine levels were evaluated at baseline and at the third and sixth months of therapy. RESULTS: In the OXC group, serum T(4), fT(4), T(3), fT(3), and rT(3) levels were found to be decreased at the third and sixth months, the differences were significant compared to the baseline values except for fT(3) levels at the third month and fT(4) and rT(3) levels at the sixth month (p < 0.05). At the sixth month, serum T(4) level dropped below the normal reference value in 8 (32%), fT(4) in 5 (20%), T(3) in 4 (16%), and fT(3) in 3 (12%) patients. In the VPA group, mean T(4), fT(4), T(3), fT(3), and rT(3) levels at 3 and 6 months remained similar compared to the baseline values (p > 0.05). Mean serum thyroid stimulating hormone levels increased significantly at the sixth month compared to the baseline values in the VPA group (p < 0.05) while it remained unchanged in the OXC group (p > 0.05). There was no effect of either drug on urinary iodine excretion and serum TPO-ab levels remained in normal ranges throughout the study. CONCLUSIONS: In this prospective study, it is documented that children under short-term OXC or VPA therapy showed altered thyroid functions similar to the changes observed after long-term treatment. Although, the clinical significance of these results need to be evaluated with future studies, this observation of altered thyroid functions points out that thyroid functions may need to be monitored closely in children receiving antiepileptic treatment, even in the short-time interval.     

Thyroid function in girls with epilepsy with carbamazepine, oxcarbazepine, or valproate monotherapy and after withdrawal of medication

Summary: Purpose: Antiepileptic drugs may affect the serum thyroid hormone concentrations. The aim of this study was to evaluate thyroid function in 78 girls taking carbamazepine (CBZ), oxcarbazepine (OXC), or valproate (VPA) monotherapy for epilepsy and after withdrawal of the treatment. Methods: Forty‐one girls taking VPA, 19 taking CBZ, and 18 taking OXC for epilepsy, as well as 54 healthy age‐matched controls, aged 8 to 18 years, participated in the study. All the girls were examined clinically, and their pubertal stage was assessed. Blood samples were obtained for thyroid hormone and antibody assays. These examinations were repeated after a mean follow‐up of 5.8 years to assess thyroid function, and 64 (82%) of 78 patients and 42 (78%) of 54 controls agreed to participate in the second evaluation. Results: In the first evaluation, the mean serum thyroid hormone concentrations were lower in the girls taking CBZ [thyroxine (T₄), 70.2; SD, 10.9 nM; and free thyroxine (FT₄), 11.5; SD, 1.8 pM] or OXC (T₄, 74.9; SD, 16.4 nM; and FT₄, 11.3; SD, 1.8 pM) than in the control girls (T₄, 96.6; SD, 15.1 nM, and FT₄, 14.4; SD, 1.5 pM; p < 0.001, all comparisons). However, thyrotropin (TSH) concentrations were normal in the girls taking CBZ or OXC. Sixty‐three% of the girls taking CBZ and 67% of the girls taking OXC had serum T₄ and/or FT₄ levels below the lower limit of the reference range. The VPA‐treated girls with epilepsy had normal serum T₄ and FT₄ concentrations, but slightly increased TSH levels (3.3; SD, 1.5 mU/L; p < 0.01) compared with the control girls (2.5; SD, 1.0 mU/L). Normal serum hormone concentrations were restored in the patients who discontinued the medication. Conclusions: Both CBZ and OXC reduce serum thyroid hormone concentrations in girls with epilepsy. Conversely, VPA is associated with normal serum thyroid hormone and increased thyrotropin levels. However, our results suggest that the changes in serum thyroid hormone and thyrotropin levels are reversible after withdrawal of the medication.     

The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures

OBJECTIVE: To investigate the effect of oxcarbazepine against standard antiepileptic drug therapy (carbamazepine and valproate) on cognitive function in children and adolescents (aged 6 to <17 years) with newly diagnosed partial seizures. METHODS: A multicentre, open-label, randomised, active-control, three-arm, parallel-group, 6-month study. The primary cognitive variable, the Computerized Visual Searching Task (CVST), assessed mental information processing speed and attention. Secondary variables included additional tests assessing psychomotor speed, alertness, memory and learning, and non-verbal intelligence. RESULTS: Of 112 patients randomised, 99 completed the study. The dropout rate was 11.6%; 13 patients discontinued due to adverse events (n=5) or unsatisfactory therapeutic effect (n=8). Mean CVST time decreased in all groups, indicating an improvement of mental processing speed and no cognitive impairment in any treatment group. No statistically significant difference was observed between oxcarbazepine and combined carbamazepine/valproate. Analysis of secondary variables did not show statistically significant differences between oxcarbazepine, carbamazepine and valproate. Analysis of intelligence test results showed that the number of correct answers increased at end point in all groups. The percentage of patients remaining seizure free throughout treatment was comparable across all groups (oxcarbazepine 58%; carbamazepine 46%; valproate 54%; carbamazepine/valproate 50%). The most common adverse events were fatigue and headache for oxcarbazepine, fatigue and rash for carbamazepine, and headache, increased appetite and alopecia for valproate. CONCLUSION: Oxcarbazepine treatment over 6 months does not display any differential effects on cognitive function and intelligence in children and adolescents with newly diagnosed partial seizures relative to standard antiepileptic drug therapy. No impairment in cognitive function was observed in any treatment group over a 6-month period.     

银杏叶注射液对外伤性蛛网膜下腔出血患者疗效及脑脊液S100B的影响

目的观察银杏叶注射液对外伤性蛛网膜下腔出血(tSAH)的疗效及脑脊液S100B的影响。方法80例tSAH患者随机分为对照组和观察组,每组40例。对照组给予常规治疗,观察组在对照组基础上给予银杏叶注射液,疗程14d。治疗前后采用ELISA法检测脑脊液S100B蛋白变化,比较2组临床疗效。结果观察组总有效率明显高于对照组(P0.05);观察组脑脊液S100B蛋白在入院3~14d均明显低于对照组(P0.05)。结论银杏叶注射液对tSAH疗效显著,能明显降低脑脊液S100B蛋白水平。     

Effects of carbamazepine and oxcarbazepine on the reproductive endocrine function in women with epilepsy

PURPOSE: The aim of the study was to compare the effects of carbamazepine (CBZ) and oxcarbazepine (OXC) on the reproductive endocrine function in women with epilepsy. OXC is a novel antiepileptic drug (AED), and the occurrence of reproductive dysfunction in women treated with OXC monotherapy for epilepsy has not been studied previously. METHODS: Thirty-five women with epilepsy were examined in the Department of Neurology at Oulu University Hospital. Sixteen patients were treated with CBZ monotherapy, and nineteen patients were treated with OXC monotherapy. The subjects were clinically examined, vaginal ultrasonography was performed, and serum sex hormone concentrations were measured. RESULTS: The women taking CBZ or OXC had lower serum testosterone (T) levels and lower free androgen indexes (FAIs) than the control subjects. CBZ medication was associated with increased concentrations of serum sex hormone-binding globulin (SHBG). The patients taking OXC had higher concentrations of dehydroepiandrosterone sulfate (DHEAS) and androstendione (A) than did the women taking CBZ. Moreover, the prevalence of polycystic ovaries (PCOs) was high in the OXC-treated women. CONCLUSIONS: CBZ and OXC have different effects on the reproductive endocrine function. Although both drugs were associated with low serum T concentrations and low FAIs, only OXC was associated with a high frequency of elevated levels of A and DHEAS and with an increased prevalence of PCOs. These findings suggest that OXC may be disadvantageous for women with epilepsy and hyperandrogenism, whereas CBZ may be beneficial for these women.