2020 年第 9 期 第 15 卷

法舒地尔联合奥卡西平对老年癫痫患者血清神经元特异性烯醇化酶和高迁移率族蛋白1水平的影响

Effect of fasudil combined with oxcarbazepine on serum neuron-specific enolase and high mobility group protein 1 level in elderly patients with epilepsy

作者：范莉萍王一涵韩颖

英文作者：Fan Liping Wang Yihan Han Ying

单位：哈尔滨医科大学附属第一医院干部四病房150001 

英文单位：The Fourth Cadre Ward the First Affiliated Hospital of Harbin Medical University Harbin 150001 China

关键词：癫痫；法舒地尔；奥卡西平；神经元特异性烯醇化酶；高迁移率族蛋白1

英文关键词：Epilepsy;Fasudil;Oxcarbazepine;Neuron-specificenolase;Highmobilitygroupprotein1

• 摘要：

• 目的 探讨法舒地尔联合奥卡西平治疗对老年癫痫患者血清神经元特异性烯醇化酶（NSE）和高迁移率族蛋白1（HMGB1）水平的影响。方法 选取2013年6月至2016年6月哈尔滨医科大学附属第一医院收治的老年癫痫患者100例，依据随机数字表法分为法奥组和单奥组，每组50例。单奥组口服奥卡西平（300 mg/次，2次/d）治疗，法奥组在此基础上联合静脉滴注法舒地尔（60 mg/次，1次/d）治疗，疗程为2周。治疗前后检测患者血清NSE和HMGB1水平，通过脑血流灌注显像检查测定病灶区与全脑血流比值（Ff）和血流功能变化率（BFCR），判断脑电图恢复效果及癫痫发作控制效果，记录不良反应发生情况。结果 治疗后2组血清NSE和HMGB1水平均明显低于治疗前［法奥组：（11.5±3.1）μg/L比（26.0±3.8）μg/L、（2.3±0.7）μg/L比（2.8±0.7）μg/L，单奥组：（15.5±2.7）μg/L比（25.6±3.9）μg/L、（2.6±0.7）μg/L比（2.9±0.7）μg/L］，且法奥组明显低于单奥组，差异均有统计学意义（均P＜0.05）。治疗后2组Ff明显高于、BFCR明显低于治疗前［法奥组：（10.3±3.1）%比（8.2±2.9）%、（7.7±2.2）%比（9.8±3.8）%，单奥组：（8.9±3.0）%比（8.1±2.8）%、（8.7±3.0）%比（9.8±3.9）%］，且法奥组Ff明显高于、BFCR明显低于单奥组，差异均有统计学意义（均P＜0.05）。法奥组脑电图恢复总有效率和癫痫发作控制总有效率均明显高于单奥组［94.0%（47/40）比78.0%（39/50）、96.0%（48/50）比80.0%（40/50）］，差异均有统计学意义（均P＜0.05）。2组不良反应发生率差异无统计学意义（P＞0.05）。结论 法舒地尔联合奥卡西平治疗可有效改善老年癫痫患者的脑血流状况和血清NSE及HMGB1水平，有利于患者癫痫发作控制和脑电图恢复，且具有良好的安全性。

• Objective To observe the effect of fasudil combined with oxcarbazepine on serum levels of neuron-specific enolase(NSE) and high mobility group protein 1(HMGB1) in elderly patients with epilepsy. Methods A total of 100 elderly epileptic patients admitted to the First Affiliated Hospital of Harbin Medical University from June 2013 to June 2016 were randomly divided into fasudil＋oxcarbazepine group and oxcarbazepine group, with 50 cases in each group. The oxcarbazepine group took oxcarbazepine 300 mg/time, 2 times/d; the fasudil＋oxcarbazepine group had intravenous administration of fasudil 60 mg/time, 1 times/d on the basis of oxcarbazepine. Serum levels of NSE and HMGB1 were tested before and after treatment. Blood flow ratio of focal area to the whole brain（Ff） and blood flow change rate（BFCR） were tested by cerebral blood flow perfusion imaging. Electroencephalogram（EEG） recovery, epileptic attack control effect and adverse reactions were analyzed. Results After treatment, serum levels of NSE and HMGB1 were significantly lower than those before treatment in both groups［fasudil＋oxcarbazepine group：（11.5±3.1）μg/L vs （26.0±3.8）μg/L,（2.3±0.7）μg/L vs （2.8±0.7）μg/L; oxcarbazepine group：（15.5±2.7）μg/L vs （25.6±3.9）μg/L,（2.6±0.7）μg/L vs （2.9±0.7）μg/L］; NSE and HMGB1 in fasudil＋oxcarbazepine group were significantly lower than those in oxcarbazepine group（all P＜0.05）. After treatment, Ff was significantly higher and HMGB1 was significantly lower than those before treatment in both groups［fasudil＋oxcarbazepine group： （10.3±3.1）% vs（8.2±2.9）%,（7.7±2.2）% vs（9.8±3.8）%; oxcarbazepine group： （8.9±3.0）% vs（8.1±2.8）%,（8.7±3.0）% vs（9.8±3.9）%］; Ff in oxcarbazepine group was significantly higher and HMGB1 was significantly lower than those in oxcarbazepine group（all P＜0.05）. EEG recovery rate and epileptic attack control rate in fasudil＋oxcarbazepine group were significantly higher than those in oxcarbazepine group［94.0%（47/40） vs 78.0%（39/50）, 96.0%（48/50） vs 80.0%（40/50）］（both P＜0.05）. Adverse reaction rate showed no significant difference between groups（P＞0.05）. Conclusion Fasudil combined with oxcarbazepine treating elderly patients with epilepsy can effectively improve cerebral blood flow, increase increase serum NSE and HMGB1 levels, reduce epileptic attack and promote EEG recovery; the adverse reactions are tolerable.