视频脑电图鉴别诊断癫痫患者睡眠障碍、认知障碍的临床价值研究

Clinical Value of Video EEG in the Diagnosis of Sleep Disorders and Cognitive Impairment in Patients with Epilepsy

目的:探讨视频脑电图诊断癫痫患者睡眠障碍、认知障碍的临床价值。方法:选取2014年1月~2016年12月在我院神经内科进行诊治的癫痫患者236例作为癫痫组,另选取同期的健康患者家属或者其他健康体检者236例作为正常对照组,对两组进行视频脑电图联合睡眠参数分析;并对癫痫组视频脑电图联合认知参数进行分析。结果:癫痫组睡眠Ⅰ~Ⅱ期时间显著长于正常对照组且具有统计学差异(P=0.000),睡眠Ⅲ~Ⅳ期时间显著短于正常对照组且具有统计学差异(P=0.000),睡眠时相转换频率、觉醒指数均显著高于正常对照组且均具有统计学差异(P=0.000);清醒期、睡眠期不同痫样放电指数(IED)的WAIS-RC IQ和WMS-RC MQ均具有统计学差异(P<0.05),10%<IED≤50%者的WAIS-RC IQ和WMS-RC MQ均显著低于1%<IED≤10%者且均具有统计学差异(P<0.05),IED 10%可能是痫样放电影响患者认知功能的最低阈值。结论:视频脑电图在癫痫患者睡眠障碍、认知障碍识别中具有重要的临床价值。

Objective： To explore the clinical value of video EEG in the diagnosis of sleep disorders and cognitive impairment in patients with epilepsy. Methods： 236 cases of patients with epilepsy from January 2014 to December 2016 were treated in the neurology depamnent in our hospital as epilepsy group, other 236 cases of the families of healthy patients and healthy persons were selected as nor- mal control group, analysed the parameters of the video EEG combined with sleep in two groups; and analyzed the parameters of the video EEG combined with cognitive in the epilepsy group. Results： Ⅰ～Ⅱ sleep in epilepsy group was significantly longer than that of nor- mal control group and the difference was statistically significant （t=-33.701, P=0.000）, Ⅲ-Ⅳ sleep time was significantly shorter than that of normal control group and the difference was statistically significant （t=61.128, P=0.000）, sleep phase frequency conversion, arousal index were significantly higher than the normal control group and were statistically different （t=15.263, 55.492, P=0.000）; awake period, sleep period epileptiform discharge index （IED） ofWAIS-RC IQ and WMS-RC MQ were statistically significant （P〈0.05）, IED 10% was probably the lowest threshold of epileptiform discharges in patients with cognitive function. Conclusion： Video EEG plays an important role in the diagnosis of sleep disorders and cognitive impairment in patients with epilepsy, which is worthy of clinical application.