正规抗癫痫治疗与老年癫痫患者抑郁情绪的相关性研究  

Correlation between antiepileptic therapy and depression in elderly epilepsy patients

作　　者：郑娴[1] 王志敏[1] 陈金莹 彭霜霜 陶晓晓[1] 金云龙[1] 辛花平[1] 肖雨[1] 叶佳媚[1] 

机构地区：[1]台州市第一人民医院神经内科,318020

出　　处：《中华老年心脑血管病杂志》2016年第8期795-798,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的观察抗癫痫药物规范化治疗后,老年患者抑郁状态的变化。方法选择2011年1月1日-12月31日在台州市第一人民医院就诊的初诊或未曾规范化治疗的≥65岁的癫痫患者45例,男性19例,女性26例,收集患者基本资料及汉密尔顿抑郁量表（Hamilton depression scale,HAMD）评分,根据HAMD评分分为抑郁组14例,非抑郁组31例,患者进行规范化抗癫痫治疗,随访2年,再次评定HAMD评分,并收集相关资料。结果抑郁组患者治疗前HAMD评分[（21.14±3.66）分vs（12.19±3.00）分]及癫痫发作频率[（2.39±0.96）次/月vs（1.39±0.68）次/月]均明显高于非抑郁组（P=0.00）。2年正规用药后,抑郁组HAMD评分高于非抑郁组[（18.00±3.26）分vs（12.09±2.68）分,P=0.00],2组癫痫发作频率无显著差异[（0.05±0.12）次/月vs（0.07±0.18）次/月,P=0.73],抑郁组8例HAMD评分下降为正常（P〈0.05）,6例仍抑郁患者HAMD评分较治疗前下降,但无明显差异（P〉0.05）。Spearman相关分析显示,治疗前HAMD评分及治疗前癫痫发作频率与抑郁改善呈正相关（r=0.77、0.55,P=0.00）。结论正规抗癫痫治疗能良好控制癫痫发作情况,并明显改善患者抑郁情绪,帮助恢复社会功能。治疗前癫痫发作越频繁,抑郁程度越重患者改善越明显。Objective To study the change of depression in elderly epilepsy patients after treated with antiepileptic drugs.Methods Forty-five epilepsy patients（19males nd 26females）aged ≥65years admitted to our hospital from 2011-01-01 to 2011-12-01 were included in this study.Their basic information and HAMD score were recorded.The patients were divided into depression group（n=14）and depression-free group（n=31）according to their HAMD score.After the patients were treated with antiepiletic drugs and followed up for two years,their HAMD score and related data were recorded.Results The HAMD score and frequency of seizure each month were significantly higher in depression group than in depression-free group（21.14±3.66 vs 12.19±3.00,2.39±0.96 vs 1.39±0.68,P=0.00）.The number of depression patients was reduced to 6after 2-year treatment（P〈0.05）.Spearman correlation analysis showed that the HAMD score and frequency of seizure before treatment were positively correlated with the improvment of depression（r=0.77,r=0.55,P=0.00）.Conclusion Antiepileptic therapy can effectively control seizures and improve depression in elderly epilepsy patients,thus helping them to restore their social functions.The higher the frequency of seizure is and the severer the depression is before treatment,the better the improvement of depression is.

关 键 词：抗惊厥药 癫痫 发作 抑郁 发病率 老年人 

分 类 号：R742.1[医药卫生—神经病学与精神病学]