抗癫癎药物对癫癎病人事件相关电位P300的影响

Effect of antiepileptic drugs on event-related potentials P300 in patients with epilepsy

目的：评价托吡酯（topiramate，TPM）与拉莫三嗪（lamotrigine，LTG）对癫癎患者认知功能的影响。方法：60例新确诊癫癎患者随机分为两组：TPM单药治疗组32例，LTG单药治疗组28例；用药前及用药2个月后分别检测事件相关电位（eventrelated potentials，ERP）P300的潜伏期（ms）及波幅（μV），并比较两种药物对P300的影响。结果：TPM治疗后，患者P300潜伏期延长、波幅降低，与治疗前相比，差异有显著意义（P〈0．01），与对照组（未用药的24名正常人）相比，差异有显著意义（P＜0．01），与LTG相比，差异有统计学意义（P〈0．05），LTG治疗组P300潜伏期延长、波幅降低，但与治疗前相比和与对照组相比，差异均无统计学意义（P＞0．05）。结论：TPM与LTG都是控制癫癎发作较理想的新型抗癫癎药物，服用治疗剂量范围内TPM对患者P300产生较明显的影响，而LTG对癫癎患者P300影响较小。服用TPM可能导致癫癎患者出现认知功能障碍，而服用LTG对癫癎患者的认知功能不仅没有损害，甚至可能有一定的改善作用。

Objective：To evaluate the effect of topiramate（TPM） and lamotrigine（LTG） on cognitive function in patients with epilepsy. Methods： A total of 60 patients with epilepsy were randomly divided into TPM treatment group （n=32） and LTG treatment group （n= 28）. Incubation period （ms） and amplitude （μV） of event-related potentials P300（ERPs） measurement were performed before drug treatment and two months after drug treatment. The effects of both durgs on P300 were compared. Results： P300 latency prolonged and amplitude decreased after treatment with TPM （P〈0.01）, The effect was more significant than that before treatment. Compared with the control group, the effect of TPM treatment was more significant（P〈0.01）. Compared with LTG treatment group, P300 latency prolonged and amplitude decreased after treatment with TPM （P〈0.05）. Compared with the data before treatment , P300 latency prolonged and amplitude decreased and there was no significant difference after treatment with LTG （P〈0. 05）. Compared with the control group, P300 latency prolonged and amplitude decreased and there was no significant difference after treatment with LTG（P〈0.05）. Conclusion：TPM and LTG are the ideal new-typed antiepileptic drugs for controlling the seizure of epilepsy. The effect of TPM on P300 is significant in patients given proper dose during the treatment, and LTG has little effect on P300 in patients with epilepsy. TPM may lead to cognitive dysfunction in patients with epilepsy, while LTG does not impair cognitive function of the patients and may have a certain improving function.