癫痫患者认知功能障碍及其影响因素相关性分析  

The correlation analysis and influencing factors of cognitive dysfunction of epilepsy patients

作　　者：梅晶[1] 李惠允[1] 

机构地区：[1]第三军医大学大坪医院神经内科,重庆400042

出　　处：《疑难病杂志》2016年第5期445-448,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨影响癫痫患者认知功能的因素,并分析影响因素之间的相关性。方法 2013年1月—2014年6月在第三军医大学大坪医院神经内科接受治疗的42例癫痫患者为观察组,选取同期进行健康体检的正常人群45例作为健康对照组。采用蒙特利尔认知评估量表(MoCA)评价研究对象认知功能,研究癫痫患者事件相关电位P300及血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和胰岛素样生长因子-1(IGF-1)的变化情况。结果观察组在语言、延迟回忆、注意力、视空间执行力及MoCA总评分水平均明显低于健康对照组,差异具有统计学意义(t=2.845、12.210、6.775、8.375、11.580,P均<0.01);观察组患者P300的反应时间及潜伏期明显长于健康对照组,差异具有统计学意义(t=3.816、5.672,P<0.01),而P300波幅低于健康对照组,差异具有统计学意义;观察组患者血清中TNF-α、IL-6水平明显高于健康对照组,差异具有统计学意义(t=2.129、7.199、37.460,P<0.05),而IGF-1水平低于健康对照组,差异具有统计学意义(t=6.764,P<0.01)。观察组患者MoCA与P300的潜伏期呈显著负相关(r=-0.533,P<0.01),与血清中IGF-1呈正相关(t=0.452,P=0.003)。结论癫痫患者MoCA评分与事件相关电位P300的潜伏期呈显著负相关,与血清中IGF-I呈显著正相关。Objective To explore the influencing factors of cognitive function in patients with epilepsy,and to analyze the correlation between the influencing factors.Methods To analyze the clinical data of 42 cases of epilepsy patients at Daping Hospital of Third Military Medical University,Department of Neurology from January 2013 to 2014 June,they were enrolled as the observation group,selected the same period health examination normal population of 45 cases as healthy control group.The Montreal Cognitive Assessment Scale（MoCA） were used to assess cognitive function,events in patients with epilepsy related potential P300 and serum tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6） and insulin-like growth factor1（IGF-1）.Results The observation group＇s language,delayed recall,attention,visual spatial ability and MoCA total score level were significantly lower than the healthy control group,the difference was statistically significant（t =2.845,12.210,6.775,8.375,11.580,P〈0.01）;the observation group＇s P300 reaction time and incubation period were significantly longer than the healthy control group,the difference were statistically significant（t =3.816,5.672,P〈0.01）.The amplitude of P300 in observation group was lower than that of the control group,the difference was statistically significant（t =2.129,P = 0.036）;TNF-α level in observation group was significantly higher than the control group（t =7.199,P〈0.01）,IL-6（t =37.46,P〈0.01）,and IGF-1 level（t =6.764,P〈0.01） were lower than that of the healthy control group,and the difference were statistically significant.Observation group＇ s MoCA and P300 latency showed a significant negative correlation（r =-0.533,P〈0.01）,and serum IGF-1 was positively correlated（t =0.452,P =0.003）.Conclusion MoCA was negatively correlated with epilepsy score and P300 latency,and serum IGF-1 showed a significant positive correlation.

关 键 词：癫痫 认知功能障碍 蒙特利尔认知评估量表 事件相关诱发电位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]