丙戊酸钠对颞叶性癫痫患者记忆能力及手术预后的影响

Effect of sodium valproate on memory ability and surgical prognosis of patients with temporal lobe epilepsy

目的探讨丙戊酸钠对颞叶性癫痫（TLE）患者记忆能力及手术预后的影响。方法选取2012年4月至2015年1月入院接受外科手术治疗的54例TLE患者为受试对象，随机数字表法分为A、B两组各27例。B组予以卡马西平片口服方案，A组则联合丙戊酸钠缓释片口服方案。观察对比两组受试者治疗前、治疗12个月后中国韦氏成人智力量表（WAIS—RC）评分结果及记忆认知障碍严重程度变化差异，记录其术后12个月内癫痫发作率及用药不良反应发生情况。结果治疗12个月后，两组WAIS—RC评分均较治疗前显著提升，且A组〉B组（P〈0．05）；A组记忆认知障碍评估结果为正常或轻度障碍者共计24例（88．9％），均显著高于同组治疗前的22．2％和B组治疗后的55．6％（P〈0．05）；术后12个月内，A组癫痫未发作率为74．1％，显著高于B组的37．0％（P〈0．05）；两组受试者用药后均无严重不良反应致中途退出治疗病例，A组轻微不适症状发生率为22．2％，同B组的18．5％比较差异无统计学意义（P〉0．05）。结论将丙戊酸钠口服方案应用于TLE患者的术后治疗中，能有效改善其记忆认知能力，对促进患者预后恢复有利。

Objective To investigate the effect of sodium valproate on memory ability and surgical prognosis of patients with temporal lobe epilepsy （TLE）. Methods 54 cases of TLE admitted to our hospital from April 2012 to January 2015 were selected as subjects, and randomly divided into A and B groups, 27 cases in each group. Group B received oral carbamazepine tablets, and group A received oral sodium valproate sustained- release tablets on the basis. Observed and compared China Wechsler Adult Intelligence Scale （WAIS-RC） score, the severity of memory and cognitive impairment before and 12 months after treatment, observed the incidence of epileptic seizure and adverse drug reactions during 12 months after treatment. Results 12 months after treatment, WAIS-RC score in both two groups significantly improved, that in group A was significantly higher than that in group B （P〈0.05）; the rate of normal assessment result and mild memory and cognitive impairment in group A （88.9%） was significantly higher than that before treatment （22.2%） and that in group B （55.6%）. During 12 months after treatment, the incidence of epileptic seizure in group A was significantly higher than that in group B （74.1% vs.37.0%; P〈0.05）, there were no dropout cases caused by serious adverse drug reactions in both two groups, there was no statistically significant difference in the incidence of mild uncomfortable symptoms between group A and group B （22.2% vs.18.5%; P〉0.05）. Conclusion Sodium valproate oral regimen for TLE patients after operation, can effectively improve memory and cognitive ability, the prognosis of patients.