拉莫三嗪、丙戊酸钠对癫儿童认知功能的影响

Influence of Lamotrigine and Valproate on Cognitive Function in Children with Epilepsy

目的探讨拉莫三嗪(LTG)和丙戊酸钠(VPA)对癫儿童认知功能的影响。方法首次确诊的癫患儿76例中,36例用LTG单药治疗,40例用VAP单药治疗。用药6个月前后对二组进行智力(IQ)测定。同时选取20例健康儿童作为健康对照组。结果1.癫患儿语言智商(VIQ)、操作智商(PIQ)和总智商(FIQ)明显低于健康对照组,各项分测验得分亦均降低(Pa<0.05)。2.癫患儿用LTG治疗6个月后VIQ、PIQ、FIQ及各项分测验得分较用药前无明显变化(Pa>0.05);癫患儿用VPA治疗6个月后VIQ、PIQ、FIQ无明显变化(Pa>0.05),而在分测验中知识项得分用药后比用药前显著提高(P<0.05),编码、木块图项得分显著下降(Pa<0.05)。结论癫患儿易发生认知功能损害,且损害无选择性;癫患儿服用LTG6个月后对认知功能无影响;服用VPA6个月后FIQ未见明显变化,但在木块图和编码上有降低,而在知识项得分用药后比用药前提高,表明VPA主要影响右脑功能,而对左脑无影响。

Objective To explore the influence of lamotrigine （LTG） and valproate （VAP） on cognitive functio.n in children with epilep- sy. Methods Seventy - six epileptic children firstly diagnosed were chosen, 36 cases received LTG monotherapy and 40 cases undwent the treatment of VPA. The intelligence quotient （ IQ ） value was measured before and after 6 months treatment respectively, and 20 healthy children were selected as healthy control. Results 1. The epileptic children had poor verbal intelligence quotient （ VIQ）, performance intelligence quo- tient （PIQ） and full intelligence quotient （FIQ） compared to the control subjects （Pa〈 0.05 ）. 2. The mean VIQ, PIQ and FIQ of subjects had no significant difference of the children before and after treatment with LTG and VPA （ Pa 〉 0.05 ）. But among the subtestings, the know-ledge, wood - graph, coded score of the VPA groups had significant difference （ Pa 〈 0.05 ） before and after treatment. Conclusions The cognitive impact may be substantial and not selective in children with epilepsy. LTG has no influence on the cognition in the children with epilepsy after taking for 6 months. The FIQ of the epileptic children has no significant difference after taking VPA for 6 months. Among the subtestings, scores of the wood - graph and coded decrease while scores of the knowledge increase.