血清同型半胱氨酸、叶酸及维生素B_(12)水平与儿童癫痫认知功能异常的关系

Association of serum homocysteine,folic acid and Vitamin B_(12) levels with cognitive dysfunction in children with epilepsy

目的探讨血清同型半胱胺酸(Hcy)、叶酸及维生素B_(12)水平与儿童癫痫认知功能障碍的关系。方法本研究选择2021年1月~2023年1月100例儿童癫痫患者为观察对象,采用韦氏儿童智力量表(C-WISC)评估患儿认知功能,设为认知功能障碍组以及对照组,比较两组患儿一般资料以及血清Hcy、叶酸、维生素B_(12)水平,并分析血清指标与C-WISC评分的相关性。结果100例癫痫患儿发生认知功能障碍24例;认知功能障碍组病程、抗癫痫药物种类显著高于对照组,发病年龄显著低于对照组(P<0.05),两组性别、年龄差异无统计学意义(P>0.05);认知功能障碍组血清Hcy水平高于对照组,叶酸、维生素B_(12)水平低于对照组(P<0.05);C-WISC评分与Hcy水平呈负相关,与叶酸、维生素B_(12)水平呈正相关。结论儿童癫痫患者认知功能障碍发生率较高,可能与Hcy水平较高有关,应积极检测Hcy水平,补充叶酸、维生素B_(12)进行预防。

Objective To investigate the relationship between serum homocysteine(Hcy),folic acid and vitamin B_(12) levels and cognitive dysfunction in children with epilepsy.Methods In this study,100 pediatric epilepsy patients from January 2021 to January 2023 were selected for observation.The children were assessed for cognitive function using the Wechsler Intelligence Scale for Children(C-WISC)and were set up as a cognitive dysfunction group as well as a control group.The general data and serum Hcy,folic acid and vitamin B_(12) levels of the children in the two groups were compared.The correlation between serum indicators and C-WISC scores was also analyzed.Results Cognitive dysfunction occurred in 24 of 100 children with epilepsy.The duration of disease and type of antiepileptic drugs were significantly higher in the cognitive dysfunction group than in the control group,and the age of onset was significantly lower than in the control group(P<0.05).The differences in gender and age between the two groups were not statistically significant(P>0.05).Serum Hcy levels were higher in the cognitive impairment group than in the control group,and folic acid and vitamin B_(12) levels were lower than in the control group(P<0.05).C-WISC scores were negatively correlated with Hcy levels and positively correlated with folic acid and vitamin B_(12) levels.Conclusion The higher incidence of cognitive dysfunction in children with epilepsy may be related to higher Hcy levels and should be prevented by active testing of Hcy levels and supplementation with folic acid and vitamin B_(12).