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《Chinese Journal of Difficult and Complicated Cases》 2017-05
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Clinical results and changes in cellular immunity of patients with intractable epilepsy in treatment with levetiracetam

WU Rui;LI Haijun;WANG Liuyi;WANG Le;LIU Shengwu;Department of Neurology,Affiliated Hospital of Yan'an University;  
Objective To observe the effect of levetiracetam on refractory epilepsy and its effect on cellular immunity.Methods Eighty-four cases of patients with intractable epilepsy were selected,who were treated in hospital from February2013 to February 2015,and they were divided into the study group(42 cases) and control group(42 cases).The patients of control group were treated with carbamazepine tablets(initial dose of 5 mg·kg~(-1) · d~(-1),increase of 10 mg · kg~(-1)·d~(-1) per week until increased to 20 mg · kg~(-1)· d~(-1)) and topiramate tablets(initial dose of 0.5 mg·kg~(-1)· d~(-1),followed by weekly increase of 2 mg · kg~(-1)· d~(-1),and gradually increased to 8 mg · kg~(-1)· d~(-1)),and on the basis of the control group,the patients of study group were treated with levetiracetam(initial dose 10 mg · kg~(-1)· d~(-1),2 times/d,increased 10 mg · kg~(-1)·d~(-1) in every 2 weeks,until to 35 mg · kg~(-1)· d~(-1) and maintenance treatment).The patients of two groups were all treated for6 months.Compare the clinical effect,adverse reactions and changes of the levels of seizures,CD3~+,CD4~+,CD8~+,DR~+of two groups were compared.Results After the appropriate treatment,the patients of the study group got a total effective rate of 95.2%,which was significandy better than the 81.0%of the control group(x~2=4.086,P =0.044);the levels of seizures,CD8~+,DR~+ of the study group were significandy lower than those of the control group(t = 3.021,t =8.793,t =7.761,P =0.002,P =0.000,P =0.000);The levels of CD3~+,CD4~+,IgA,IgG,IgM of the study group were significandy higher than those of the control group(t=3.924,t =5.962,t =1.845,1 =4.427,t=2.113,P =0.000,P =0.000,P =0.034,P =0.000,P =0.018);there were nausea,dizziness,drowsiness,loss of appetite,memory loss,leukopenia,rash,mood disorders and other adverse reactions occurred in both two groups,but there were no statistically significant between the two groups(x~2=0.473,x~2=0.829,x~2=0.956,x~2=2.429,x~2=0.000,x~2=0.473,x~2=1.664,x~2=0.378;P=0.492,P=0.362,P=0.328,P=0.119,P=0.492,P=0.197,P=0.538).Conclusion Levetiracetam is effective in the treatment of intractable epilepsy patients,reduce the number of attacks,effectively improve the level of cellular immunity,safe and reliable,worthy of clinical application.
【CateGory Index】: R742.1
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