成人癫痫患者口服抗癫痫药物对认知功能和生活质量的影响  

Influence of oral anti-epilepsy drugs on the cognitive function and quality of life in adult patients with epilepsy

作　　者：陶爱华[1] 何效兵[1] 孙永安[1] 时恒屏[1] 李世滢[1] 

机构地区：[1]连云港市第一人民医院神经科,江苏省连云港市222002

出　　处：《中国临床康复》2005年第32期40-42,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察抗癫痫药物对成人癫痫患者认知功能和生活质量的影响,功能评估标准以健康人为对照。方法:选择1999-06/2002-12连云港市第一人民医院收治的≥16岁癫痫患者66例,其中继发性癫痫32,原发性癫痫26例,所有患者口服药物或维持血药浓度在相对正常范围(苯妥英钠0.2～0.4g/d或10～20μg/L;丙戊酸钠0.8～1.2g/d或40～100μg/L;卡马西平0.3～0.6g/d或20～45μg/L)。用药前及用药3个月时应用简明精神状态评定量表(共30项,分别属于11个方面,每项回答正确得1分)评估认知功能,用Spitzer生活质量指数(包括活动能力、日常生活、健康的感觉、支持、对生活的认识等5个项目,每项0～2分,评分越高越好)评估患者的生活质量,并与28例无癫痫病史的健康体检者进行对照。结果:按实际处理分析,86例进入结果分析。①Spitzer生活质量指数得分:癫痫患者5项得分均低于对照组(P<0.01);无论原发性还是继发性癫痫患者用药后活动能力、日常生活、健康的感觉和对生活的认识方面均较用药前显著提高(P<0.01);但原发性和继发性癫痫患者间比较无差异(P>0.05)。②简明精神状态评定量表得分:癫痫患者11项得分均低于对照组(P<0.01);无论原发性还是继发性癫痫患者用药后时间定向、地点定向、即刻记忆、注意计算和短时记忆得分均较用药前显著提高(P<0.01);但原发性和继发性癫痫患者间比较无差异(P>0.05)。结论:成人癫痫患者存在认知功能和生活质量下降:合理用药可改善认知功能和生活质量。AIM： To observe the effects of anti-epilepsy drugs on the cognitive function and quality of life （QOL） in adult patients with epilepsy, and take compare with healthy people as the standard of functional evaluation. METHODS： From June 1999 to December 2002, 58 patients with epilepsy aged ≥16 years, including 32 cases of secondary epilepsy and 26 cases of primary epilepsy, who were treated in Lianyungang First People＇s Hospital, received oral drug treatment or maintenance of drug concentration in blood in a relatively normal range （phenytoin sodium 0.2- 0.4 g per day or 10-20μg/L; valproate sodium 0.8-1.2 g per day or 40- 100μg/L; carbamazepine 0.3-0.6 g per day or 20-45μg/L）. Before medication and 3 months after medication, the cognitive function of the patients was assessed with the mini-mental status examination （MMSE, totally 30 items about 11 aspects, 1 points for each item with correct answer）, and their QOL was evaluated with Spitzcr QOL index （including 5 items of motor ability, daily life, sense of health, support and knowledge of life, 0-2 points for each item, the higher score the better）, The results were compared with those of 28 healthy physical examinees without history of epilepsy.RESULTS： According to actual treatment analysis, 58 cases were involved in the analysis of results. ①Scores of Spitzer QOL index： The scores of the 5 items were all lower in the patients with epilepsy than in the control group （P 〈 0.01）. After medication, the motor ability, daily life, sense of health and knowledge of life were significantly improved as compared with those before medication in patients with both primary and secondary epilepsy （P 〈 0.01）, but there were no differences between patients with primary and secondary epilepsy （P 〉 0.05）. ②Scores of MMSE： The scores of the 11 items were all lower in the patients with epilepsy than in the control group （P 〈 0.01）. After medication, the scores of time orientation, place orientation, immediate memory, atte

关 键 词：癫痫 认知 生活质量 

分 类 号：R749.1[医药卫生—神经病学与精神病学]