摘要
目的:评价托吡酯(topiramate tablet,TPM)与丙戊酸钠缓释片(sodium valproate retard tablet,VAP)对成年癫患者认知功能的影响。方法:62例新确诊成年癫患者随机分为2组,TPM组(30例)与VAP组(32例);采用自身对照研究分别于用药前及用药2个月后采用韦氏修订记忆量表(WMS-RC)与P300检查对癫患者的认知功能做出评估。结果:①服药前TPM组VAP组比较记忆商值(MQ)、ERPs检查中P3波潜伏时间P>0.05,2组间认知功能无明显差异;②TPM组较服药前1→100顺序数数分值下降、100→1倒数水平降低、数字累加分值降低、图片再认错误增加、图片记忆能力降低、图像再生错误率增加、词语联想错误增多、实物触摸困难、故事理解能力降低、顺背反背数字难度增大;ERPs检查中,N1波潜伏时间延长,P2、N2、P3波潜伏时间均明显延长,P3波波幅降低。VAP组WMS-RC测试各分项分值较用药前无显著变化;ERPs检查中,N1波潜伏时间缩短,P2、N2、P3波潜伏时间均缩短明显,P3波幅增高不明显;③WMS-RC中的短期记忆与P3波潜伏时间呈负相关。结论:TPM在加量阶段可以引起癫患者认知功能障碍;VAP对癫患者的认知功能有改善作用;将P300与WMS-RC结合用于癫患者认知功能评估,其结果更客观、全面。
Objective:To evaluate the effects of topiramate(TPM) and sodium valproate retard tablet(VAP) on cognitive function in adult patients with epilepsy. Methods:Sixty-two adult patients,newly diagnosed as epilepsy,were randomly divided into 2 groups: TPM Group (n = 30) and VAP Group (n = 32). The cognitive function of all the patients in these two groups were evaluated by the Revised Adult Wechsler memory seale(WMS-RC) and event related potentials(ERPs) before treatment and after two months administration of TPM/VAP. Results: ①Before administration of TPM : Memory Quotient (MQ) 〈 100, accounting for 26.67% ; In the ERPs, the P3 wave latency 〉359.9ms, accounting for 33.33%. Before administration of VAP: MQ 〈 100,accounting for 28.0% ; In the ERPs, the P3 wave latency 〉 359.9ms, accounting for 31.25%. There was not significant difference between these two groups with respect to the cognitive function (P 〉 0.05). ②After administration of TPM,in TPM Group the score of sequence counts of l to 100 declined (P 〈 0.01 ),the score of sequence counts of 100 tol declined(P 〈 0.05), the score of digit cumulate cognitive function declined(P 〈 0.05) ,the mistakes of cards recognition increased(P 〈 0.01 ), the function of cards remembrance declined(P 〈0.01 ), the mistakes of cards reclamation increased(P 〈 0.01),the mistakes of word association increased (P 〈 0.01 ), the object touch was more difficult (P 〈 0.01 ), the function of story apprehension declined (P 〈 0.01 )and the natural order and anti-natural order repeat of digit were more difficult (P 〈 0.01 ). In the ERPs, the N1 wave latency prolonged (P 〈 0.05) and the P2,N2 and P3 waves lateneies all prolonged significantly(P 〈 0.01 ),while the amplitude of P3 wave declined(P 〈 0.01 ). After administration of VAP,in VAP Group:the score of WMS-RC TEST in every item did not change significantly(P 〉 0.05). In the ERPs,the N1 wave latency shortened(P 〈 0.05) and the P2,N2 and P3 waves latencies all shortened significantly (P 〈 0.01 ),while the amplitude of P3 wave did not increase significantly (P 〉 0.05). ③The transient memory of WMS-RC was reversely correlated with the P3 wave latency (P 〈 0.05). Conclusion: After administrateratien of TPM, patients with epilepsy who were in the drug titration phase were more likely to suffer from many cognitive disturbers;Patients' cognitions were improved by administration of VAP;After examination of ERPs and WMS-RC ,the results of evalua- tion of cognitive function will be more objective and comprehensive.
出处
《南京医科大学学报(自然科学版)》
CAS
CSCD
北大核心
2008年第12期1587-1590,共4页
Journal of Nanjing Medical University(Natural Sciences)
关键词
托吡酯片
丙戊酸钠缓释片
癫痫
认知功能
topiramate tablet
sodium valproate retard tablet
epilepsy
cognitive function