六岁以下癫痫患儿认知功能损害的影响因素探讨  

The influence factors of cognitive impairment in epilepsy children with less than six years old

作　　者：杨湘峰[1] 尹飞[1] 

机构地区：[1]中南大学湘雅医院儿科,长沙410005

出　　处：《中国医师进修杂志》2016年第8期721-723,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨6岁以下癫痫患儿认知功能损害的影响因素。方法选取89例6岁以下癫痫患儿作为研究对象，采用Gesell发育诊断量表（GDDS）进行神经心理学测试，并行头颅影像学检查（CT或MRI）及动态脑电图（EGG）等。结果所有患儿适应性行为、大运动行为、精细运动行为、语言行为及个人-社交行为分别为（82.98±14.02）、（85.86±13.79）、（83.14±13.44）、（84.75±13.29）、（84.99±14.37）分，各项发育商平均值均大于75分，各项之间比较差异无统计学意义（P〉0.05）。适应性行为、大运动行为、精细运动行为、语言行为及个人-社交行为测试结果显示，发育迟缓患儿分别占21.35%（19/89）、19.10%（17/89）、16.85%（15/89）、24.72%（22/89）及22.47%（20/89），中至重度发育迟缓占3.37%（3/89）、3.37%（3/89）、4.49%（4/89）、3.37%（3/89）及3.37%（3/89）。多因素分析结果显示，癫痫首次发作年龄和头颅影像学表现与适应性行为、大运动行为、精细运动行为及个人-社交行为有相关性（P＆lt;0.05）。结论癫痫首次发作年龄及头颅影像学表现是影响6岁以下癫痫患儿认知功能损害的主要因素，在临床上应重视改善癫痫患儿的认知预后，提高生命质量。Objective To investigate the influence factors of cognitive impairment in epilepsy children with less than 6 years old. Methods Eighty-nine epilepsy children with less than 6 years old were selected. The neuropsychological detection was tested by Gesell developmental diagnostic scale （GDDS）, and head imaging examination （CT or MRI） and ambulatory electroencephalogram （EGG） were checked. Results The scores of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal- social behavior were （82.98 ± 14.02）, （85.86 ± 13.79）, （83.14 ± 13.44）, （84.75 ± 3.29） and （84.99 ± 14.37） scores, the average development quotient of the children with epilepsy were greater than 75 scores, and there were no statistical differences among them （P 〉 0.05）. According to the test results of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal-social behavior, the rates of developmental delay children were 21.35% （19/89）, 19.10% （17/89）, 16.85% （15/89）, 24.72% （22/89） and 22.47% （20/89）, and the rates of moderate to severe developmental delay were 3.37% （3/89）, 3.37% （3/89）, 4.49% （4/89）, 3.37% （3/89） and 3.37%（3/89）. Multivariate analysis results showed that first onset age of epilepsy and head imaging performance were correlated with adaptive behavior, big sports behavior, fine motor behavior and personal-social behavior （P ＆lt; 0.05）. Conclusions The first onset age of epilepsy and head imaging performances are the major factors in cognitive performance in epilepsy children with less than 6 years old, so clinical attention should be paid to improve the prognosis of cognitive outcome of epilepsy children, and improve their life quality.

关 键 词：癫痫 儿童 认知障碍 因素分析 统计学 

分 类 号：R742.1[医药卫生—神经病学与精神病学]