失神癫痫患儿睡眠和神经认知状况分析

Analysis of sleep and cognitive function in children with absence epilepsy

目的:探讨失神癫痫患者的睡眠变化,并探讨失神癫痫患者的睡眠与神经认知之间的关系。方法:选取2022年1月—2023年2月安徽省儿童医院神经内科癫痫门诊和住院治疗的失神癫痫患儿40例,20例新诊断癫痫患儿设为新诊断癫痫组,20例正在服用丙戊酸钠单药治疗的患儿设为丙戊酸钠组,同期招募20名年龄和性别匹配的健康儿童作为对照组。用儿童睡眠习惯问卷(CSHQ)、匹兹堡睡眠质量指数(PSQI)和韦氏第四版儿童智力量表(WISC-Ⅳ)对三组儿童的睡眠和智力情况进行评价,比较三组儿童睡眠质量和认知水平。结果:三组CSHQ评分比较,差异有统计学意义(P<0.05),事后比较结果表明,新诊断癫痫组和丙戊酸钠组的CSHQ评分高于对照组,差异有统计学意义(P<0.05)。三组PSQI评分比较,差异有统计学意义(P<0.05),事后比较结果表明,丙戊酸钠组的PSQI评分高于对照组,差异有统计学意义(P<0.05)。三组言语理解、知觉推理、工作记忆、加工速度指数和总智力比较,差异均有统计学意义(P<0.05);事后比较结果表明,新诊断癫痫组言语理解指数低于对照组,两癫痫组知觉推断指数、工作记忆指数和加工速度指数均低于对照组,新诊断癫痫组知觉推断指数、工作记忆指数和加工速度指数均低于丙戊酸钠组,差异均有统计学意义(P<0.05)。从回归模型看,CSHQ、PSQI评分与总智力呈负相关(P<0.05)。结论:失神癫痫患儿的睡眠质量明显受损。失神儿童有轻微的智力减退。失神癫痫患儿的睡眠会对认知产生负面影响。

Objective The purpose of this study is to investigate sleep changes in patients with absence epilepsy and to explore the association between sleep and neurocognition in patients with absence epilepsy.Methods Forty children with absence of epilepsy were selected from outpatient and inpatient epilepsy clinics of the Department of Neurology,Anhui Children's Hospital,from January 2022 to February 2023.20 newly diagnosed epileptic children were set up as the newly diagnosed epilepsy group,and 20 children who were on valproate monotherapy were set up as the valproate group,while 20 age-and gender-matched healthy children were recruited as the control group during the same period.The Children's Sleep Habits Questionnaire(CSHQ),the Pittsburgh Sleep Quality Index(PSQI),and the Wechsler Intelligence Scale for Children-The Fourth Vision(WISC-IV)were used to evaluate the sleep and intelligence of the three groups,and to compare the sleep quality and cognitive level of the three groups.Results The difference of CSHQ scores among the three groups was statistically significant(P<0.05).The results of post hoc comparison showed that the CSHQ scores of the newly diagnosed epilepsy group and the sodium valproate group were higher than those of the control group,and the difference was statistically significant(P<0.05).The PSQI scores of the three groups were compared,and the difference was statistically significant(P<0.05).The results of post-hoc comparison showed that the PSQI score of the sodium valproate group was higher than that of the control group,and the difference was statistically significant(P<0.05).There were significant differences in verbal comprehension,perceptual reasoning,working memory,processing speed index and total intelligence among the three groups(P<0.05).The results of post-hoc comparison showed that the speech comprehension index of the newly diagnosed epilepsy group was lower than that of the control group.The perceptual inference index,working memory index and processing speed index of the two epilepsy groups were lower than those of the control group.The perceptual inference index,working memory index and processing speed index of the newly diagnosed epilepsy group were lower than those of the sodium valproate group,and the differences were statistically significant(P<0.05).CSHQ and PSQI scores were negatively correlated with total intelligence(P<0.05).Conclusions The sleep quality of children with absence epilepsy is significantly impaired.Lost children have mild mental retardation.Sleep in children with lost epilepsy has a negative impact on cognition.