成人癫痫患者生态学执行功能特点及其影响因素

Features and influencing factors concerning the ecological executive function of adult epileptics

目的探讨成人原发性或可能症状性癫痫患者生态学执行功能特点及其影响因素。方法对120例成人原发性或可能症状性癫痫患者和120例性别、年龄、婚姻、受教育年数等与之严格匹配的健康成人,采用成人版执行功能行为评定量表自评问卷(BRIEF-A)进行评定,比较两组间生态学执行功能各指标的差异;应用多元回归分析探讨癫痫病自身因素与BRIEF-A量表各因子的相关性。结果与对照组相比,癫痫组在执行总分(GEC)、行为管理指数(BRI)及其抑制、转换、情感调控、自我监控因子、元认知指数(MI)及其任务启动、工作记忆、计划、组织、任务监控因子得分均明显高于对照组(P<0.05)。多元逐步回归分析显示发作类型、发作频率、发作控制与否、抗癫痫药物应用种类4个临床特征与BRIEF-A显著相关(P<0.05);未发现癫痫患者病程、性别、年龄、婚姻状况、受教育程度、首发年龄等与BRIEF-A相关。结论成人原发性或可能症状性癫痫患者存在生态学执行功能损害,其生态学执行功能障碍与癫痫发作类型、发作频率、发作控制与否、抗癫痫药物应用密切相关。

Objective To explore the features and relevant factors of ecological executive function in adults with id- iopathic or probably symptomatic epilepsy. Methods 120 adults with idiopathic or probably symptomatic epilepsy were compared strictly with 120 healthy controls of the same gender, age , marriage and educational degree. The differences in ecological executive function were compared between the two groups with the Behavior Rating Inven- tory of Executive Function-adult version（BRIEF-A） ;apply multiple stepwise linear regression analysis was used to explore the correlations between epileptic factors with projects of BRIEF-A. Results Compared with controls, the epileptics yielded higher scores significantly on all projects of BRIEF-A （P 〈 0.05 ） ：global executive composite, be- havioral regulation index, inhibition, shift, emotion control, self-monitoring, metacognition index, initiation, working memory, plan, organization ,task monitor. Multiple stepwise linear regression analysis showed that four clinical fea- tures videlicet seizure type, seizure frequency, epilepsy control and antiepileptic drugs were closely related to BRIEF-A while factors such as course of disease, gender, age, marriage, educational degree, initial age were not rele- vant to BRIEF-A. Conclusion The ecological executive function of adults with idiopathic or probably symptomatic epilepsy impairment is affected by seizure type, seizure frequency, epilepsy control and antiepileptic drugs.