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目的:对比分析拉考沙胺与卡马西平治疗新确诊成人癫痫的效果。方法:回顾性抽取2021年9月至2023年9月漯河市中心医院收治的新确诊成人癫痫患者80例，按随机数字表法分为拉考沙胺组(40例，采用拉考沙胺治疗)与卡马西平组(40例，采用卡马西平治疗)。比较两组疗效、癫痫发作情况、认知功能、同型半胱氨酸(Hcy)、细胞间黏附分子－1(ICAM－1)、总胆固醇(TC)、三酰甘油(TG)水平及不良反应发生率、复发率。结果:拉考沙胺组总有效率(95.00%，38/40)高于卡马西平组(77.50%，31/40)， P<0.05。治疗后，拉考沙胺组癫痫发作频率、癫痫样放电次数、累及导联数少于卡马西平组( P<0.05)，认知功能评分高于卡马西平组( P<0.05)，Hcy、ICAM－1水平低于卡马西平组( P<0.05)，TC、TG水平低于卡马西平组( P<0.05)。两组不良反应发生率比较差异未见统计学意义( P>0.05)。拉考沙胺组复发率(5.00%，2/40)低于卡马西平组(20.00%，8/40)， P<0.05。 结论:与卡马西平相比，拉考沙胺治疗新确诊成人癫痫患者的效果更好，可降低脑损伤标志物表达，改善癫痫发作情况和认知功能，减轻对血脂水平的影响，且复发率低。

Objective:To compare the effects of lacosamide and carbamazepine in the treatment of newly diagnosed epilepsy in adults.Methods:A total of 80 adult patients with newly diagnosed epilepsy admitted to Luohe Central Hospital from September 2021 to September 2023 were retrospectively selected, and they were divided into a lacosamide group (40 cases, treated with lacosamide) and a carbamazepine group (40 cases, treated with carbamazepine) by random number table method. The curative effect, seizure condition, cognitive function, homocysteine (Hcy), intercellular adhesion molecule-1 (ICAM-1), total cholesterol (TC), triglyceride (TG), incidence of adverse reactions, and the recurrence rate were compared between the two groups.Results:The total effective rate of the lacosamide group (95.00%, 38/40 ) was higher than that of the carbamazepine group (77.50%, 31/40), P<0.05. Compared with the carbamazepine group, the seizure frequency, the number of epileptiform discharges, and the number of involved leads in the lacosamide group were less after treatment ( P<0.05). After treatment, the cognitive function score in the lacosamide group was higher ( P<0.05), the levels of Hcy and ICAM-1 in the lacosamide group were lower ( P<0.05), the levels of TC and TG in the lacosamide group were lower compared with the carbamazepine group ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). The recurrence rate in the lacosamide group was 5.00% (2/40), lower than the 20.00% (8/40) in the carbamazepine group ( P<0.05). Conclusions:Compared with carbamazepine, lacosamide has a better effect in treating adult patients with newly diagnosed epilepsy, it can reduce the expression of brain injury markers, improve the seizure condition and cognitive function, and reduce the impact on levels of blood lipids, with a low recurrence rate.