苯妥因钠、丙戊酸钠、卡马西平对癫痫患者智力的影响

The Effects of Phenytoin,Valproate and Carbamazepine on Intelligence in Epileptic Patients

抗癫痫药物造成认知功能的损害及损害程度至今仍无明确结果。为此，我们对４６例全身性强直一阵挛发作的癫痫患儿进行了服药前后的智力测验，并以１６例健康同龄人对照，以检测苯妥因钠、丙戊酸钠、卡马西平对智力的影响。结果表明：服药３～４个月后，在血药浓度水平于治疗范围内的情况下，苯妥因钠组病人的操作智商、知觉组织智商较对照组低（Ｐ＜０．０５），而丙戊酸钠组及卡马西平组相互比较并与对照组比较则无显著差异。提示苯妥因钠影响患儿的记忆、注意、抽象思维，空间知觉及学习能力。

It was uncertain for a long time that antiepileptic drugs impaired the congitive functions and the severity degrees in epileptic patients.So the effects of phenytoin,valproate and carbamazepine on intelligence were assessed in 46 children who had generalized tonic -clonic seizures .The intelligence test was applied before and after a 3-4 months course of treatment with these medicines .Sixteen age -matched healthy controls were examined simultaneouly . The results have shown that after a 3-4 month period of treatment ,when the drugs plasma levels were within their therapeutic ranges ,Performance Intelligence Quotients and Percept Organization Quotient in the patients treated with phenytoin were lower than those of controls( P <0.05),but there were no significant differences between the patients treated with valproate ,carbamazepine and the controls .The conclusion was that phenytoin may affects memory ,attention ,abilities of abstract thought and space perception ,as well as learning ability.Valproate and carbamazepine did not seem to impair intelligence .