颞叶癫痫患者认知功能及其影响因素的研究

The study on cognitive function and relative factors in patients with temporal lobe epilepsy

目的观察颞叶癫痫患者的认知功能状况,并进一步探讨社会人口学、临床发作、癫痫样放电等因素对患者认知功能的影响。方法对129例颞叶癫痫患者和90名健康对照者进行韦氏成人智力量表中国修订本(WAIS-RC)和临床记忆量表测定。结果颞叶癫痫患者总智商(full intelligence quotient,FIQ)、言语智商(verbal intelligence quotient,VIQ)、操作智商(performance intelligence quotient,PIQ)及记忆商(memory quotient,MQ)均明显低于健康对照者(P<0.001)。癫痫患者文化程度越高,其IQ及MQ越高(P<0.01);癫痫患者发作越频繁,其IQ及MQ越低(P<0.01);癫痫患者癫痫样放电越明显,其IQ及MQ越低(P<0.01)。多元逐步回归分析显示,影响患者FIQ和MQ的因素依次为发作频率和脑电图癫痫样放电。结论颞叶癫痫患者存在不同程度的认知功能障碍。关注颞叶癫痫患者的认知功能以及合理选择治疗方法、尽快控制癫痫发作是避免和减少患者认知功能损害的重要前提。

Objective To evaluate the cognitive function status in patients with temporal lobe epilepsy and the impact of sociodemographic factors,clinical seizure factors and epileptiform discharge on cognition.Methods 129 patients with temporal lobe epilepsy and 90 matched healthy controls who met the entry criteria were included in our study.All of them were assessed with WAIS-RC and Chinese clinical memory test.Results The scores of tests including FIQ、VIQ、PIQ and MQ in patients with temporal lobe epilepsy were significantly lower than in healthy controls（P〈0.001）.The higher eduction was,the higher scores of IQ and MQ were（P〈0.01）.The more frequent seizure was,the lower scores of IQ and MQ were（P〈0.01）.The more severe of epileptiform discharge was,the lower scores of IQ and MQ were（P〈0.01）.Mutiple linear regression was used to examine the relationship among IQ,MQand relative factors.It showed that seizure frequency and epileptiform discharge were the main relative factors that impact on cognitive function.Conclusion Cognition deficts are common in patients with temporal lobe epilepsy.Recognition and treatment of comorbid cognition deficts is an important consideration in temporal lobe epilepsy.Choice reasonable treatment strategy to achieve good seizure control is another important one.