癫痫患者的认知功能损害及其独立危险因素分析

Investigation of cognitive function in epilepsy and the independent risk factors.

目的探讨新诊断的癫痫患者认知功能改变的独立危险因素。方法对我院癫痫专科新诊断为癫痫并符合研究要求的患者60例,治疗前接受韦氏智力量表测定,并记录临床情况,比较其智商及构成因子与对照组的差异;进行认知功能影响因素分析,筛选出影响癫痫患者认知功能的独立危险因素。结果癫痫患者的全量表智商、言语智商和操作智商以及言语理解因子、知觉组织因子均低于健康对照(P<0.05),成人亚组和儿童亚组亦见相似结果(P<0.05)。病程和发作频率均与患者的全量表智商、言语智商和操作智商呈负相关(P<0.05);发病年龄、发作类型、家族史以及致灶是否在优势半球,均与癫痫患者智商水平无关。进一步以病程作协变量,总量表智商和发作频率的相关度为r=-0.243(P<0.01);以发作频率作协变量,总量表智商和病程的相关度r=-0.155(P>0.05)。结论癫痫患者人群的智商平均水平低于正常人群的智商平均水平;癫痫发作的频率是癫痫患者总体认知功能低下的独立危险因素。

Objective To evaluate the cognitive function of patients with epilepsy and to explore the effect of the related factors of epilepsy on cognition in China. Methods 60 registered patients, newly diagnosed cryptogenic epilepsy and met the criteria of the study, were arranged for the Wechsler intelligence scale and registered their clinical manifestation before the treatment. 60 controls were paired healthy volunteers. Results Epileptic patients had lower FIQ, VIQ, PIQ, VCF and POF than the healthy controls, with significant difference. Similar results were also reported in the adult subgroup and child subgroup. FIQ, VIQ and PIQ had negative correlation with duration of seizure disorders, and seizure frequency. Suggesting duration as covariant, correlation index of FIQ and seizure frequency was -0. 243 （P 〈 0. 01 ） while suggesting seizure frequency as covariant, the counterpart was - 0. 092 （ P 〉 0.05 ）. Conclusion These findings indicate that IQs of patients with epilepsy are lower than those of the healthy population and that seizure frequency is the independent risk factor of impaired cognition in epilepsy.