标题：左乙拉西坦片联合奥卡西平片治疗癫痫的疗效及对患者血清miR-222、BAFF水平的影响

      作者：康乐乐 1，苗婵婵 1，高海茸 2    1.延安大学附属医院神经内科，陕西 延安 716000；2.延安市人民医院神经内科，陕西 延安 716000

      卷次： 2023年34卷5期

      【摘要】 目的 探讨左乙拉西坦片联合奥卡西平片治疗癫痫的疗效及对患者血清微小核糖核酸-222 (miR-222)、B细胞活化因子(BAFF)水平的影响。方法 选择2019年2月至2021年10月延安大学附属医院收治的106例癫痫患者进行前瞻性研究，按照随机数表法分为观察组和对照组各53例。对照组患者给予奥卡西平片治疗，观察组患者在对照组基础上联合左乙拉西坦片治疗，两组患者均持续治疗6个月。比较两组患者治疗后的临床疗效，治疗前后的血清miR-222、BAFF水平、痫样放电数量、累及导联数、蒙特利尔认知量表(MoCA)评分以及治疗期间的不良反应发生情况。结果 治疗后，观察组患者的临床疗效总有效率为94.34%，明显高于对照组的77.36%，差异有统计学意义(P<0.05)；治疗后，观察组患者的血清miR-222、BAFF水平分别为0.86±0.15、(5.21±0.87) ng/mL，明显低于对照组的1.03±0.12、(6.89±1.11) ng/mL，差异均有统计学意义(P<0.05)；治疗后，观察组患者的痫样放电、累及导联数分别为(9.84±1.67) t/180 s、(4.63±0.77) t/180 s，明显低于对照组的(12.17±1.83) t/180 s、(5.85±0.92) t/180 s，MoCA评分为(27.24±1.52)分，明显高于对照组的(26.38±1.30)分，差异均有统计学意义(P<0.05)；治疗期间，观察组和对照组患者的不良反应总发生率分别为15.09%和11.32%，差异无统计学意义(P>0.05)。结论 左乙拉西坦片联合奥卡西平片可明显提高癫痫患者的治疗效果，且能降低血清miR-222、BAFF的表达水平，具有临床推广应用价值。
      【关键词】 癫痫；奥卡西平片；左乙拉西坦片；微小核糖核酸-222；B细胞活化因子；脑电图；认知功能
      【中图分类号】 R742.1 【文献标识码】 A 【文章编号】 1003—6350（2023）05—0625—04

Efficacy of Levetiracetam combined with oxcarbazepine tablets in the treatment of epilepsy and its effect onserum miR-222 and B cell activating factor levels in the patients.
KANG Le-le 1, MIAO Chan-chan 1, GAO Hai-rong 2.1. Department of Neurology, Affiliated Hospital of Yan'an University, Yan'an 716000, Shaanxi, CHINA; 2.Department ofNeurology, Yan'an People's Hospital, Yan'an 716000, Shaanxi, CHINA
【Abstract】 Objective To study the efficacy of levetiracetam combined with oxcarbazepine tablets in the treat-ment of epilepsy and its effect on serum levels of MicroRNA-222 (miR-222) and B cell activating factor (BAFF) in thepatients. Methods A total of 106 patients with epilepsy admitted to Affiliated Hospital of Yan'an University from Feb-ruary 2019 to October 2021 were selected for a prospective study. They were divided into an observation group and acontrol group according to random number table method, with 53 patients in each group. The patients in the controlgroup were treated with oxcarbazepine tablets, and the patients in the observation group were treated with levetiracetamtablet on the basis of the control group, for 6 months. The clinical efficacy after treatment, the serum miR-222, BAFFlevels, the number of epileptic discharges, the number of involved leads, Montreal Cognitive Scale (MoCA) score beforeand after treatment, and the incidence of adverse reactions during treatment were compared between the two groups.Results After treatment, the total effective rate in the observation group was 94.34%, which was significantly higherthan 77.36% in the control group (P<0.05). After treatment, the serum miR-222 and BAFF levels in the observationgroup were 0.86±0.15 and (5.21±0.87) ng/mL, which were significantly lower than 1.03±0.12 and (6.89±1.11) ng/mL inthe control group (P<0.05). After treatment, the number of epileptic discharge and involved leads in the observationgroup were (9.84±1.67) t/180 s and (4.63±0.77) t/180 s, which were significantly lower than (12.17±1.83) t/180 s and(5.85±0.92) t/180 s in the control group, and the MoCA score was (27.24±1.52) points, significantly higher than (26.38±1.30) points in the control group (P<0.05). During treatment, the total incidence of adverse reactions in the observationgroup and control group was 15.09% and 11.32%, with no statistically significant differences (P>0.05). Conclusion Le-vetiracetam combined with oxcarbazepine tablets can significantly improve the therapeutic effect of epilepsy, and can re-duce the expression serum miR-222 and BAFF levels, which have significant clinical application value.
      【Key words】 Epilepsy; Oxcarbazepine tablets; Levetiracetam tablet; MicroRNA-222; B cell activating factor;Electroencephalogram; Cognitive function