儿童失神癫痫的生态学执行功能特点及其影响因素  

Features and relevant influencing factor of ecological executive function in children with childhood absence epilepsy

作　　者：林丽 周农[2] 杨斌 Lin Li;Zhou Nong;Yang bin(Department of Neurology,Anhui Provincial Children′s Hospital,Hefei 230051,China;Department of Neurology,the First Affiliated Hospital,Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽省儿童医院神经内科,合肥230051 [2]安徽医科大学第一附属医院神经内科,合肥230022

出　　处：《中国医师进修杂志》2021年第3期197-201,共5页Chinese Journal of Postgraduates of Medicine

基　　金：安徽省卫生计生委科研计划 (2017ek003);安徽高校省级自然科学研究项目 (KJ2012A175)。

摘　　要：目的研究儿童失神癫痫(CAE)的生态学执行功能损害情况及其影响因素。方法2017年4月至2020年7月采用执行功能行为评定量表(BRIEF)父母版对安徽省儿童医院40例CAE患儿(CAE组)和40例健康体检儿童(对照组)进行生态学执行功能评估,比较两组生态学执行功能的差异。结果CAE组BRIEF总分、行为管理指数(BRI)和元认知指数(MI)明显高于对照组[(52.03±10.89)分比(44.05±5.06)分、(49.45±9.93)分比(43.85±4.70)分和(53.18±11.24)分比(44.95±5.32)分],差异有统计学意义(P<0.01)。多元逐步回归分析结果显示,抑制、转换、感情控制、任务启动、工作记忆、计划、组织、任务监控、MI、总分与疾病控制与否相关(P<0.01),疾病控制与否对其有负向预测作用(总解释度R2=0.174、0.158、0.234、0.325、0.383、0.337、0.378、0.199、0.463和0.435);BRI与首发年龄、疾病控制与否相关(P<0.01或<0.05),首发年龄、疾病控制与否对BRI有负向预测作用(总解释度R2=0.336)。结论CAE患儿存在明显的生态学执行功能缺陷,疾病控制与否及首发年龄是影响CAE患儿生态学执行功能障碍的主要因素。Objective To explore features and relevant influencing factor of ecological executive function in children with childhood absence epilepsy(CAE).Methods Forty children with CAE(CAE group)and 40 healthy children with physical examination(control group)from April 2017 to July 2020 in Anhui Provincial Children′s Hospital were selected.The behavior rating inventory of executive function(BRIEF)parental questionnaire was used to evaluate the executive function of children.The differences of ecological executive function between 2 groups were compared.Results The BRIEF total score,behavioral regulation index(BRI)and metacognition index(MI)in CAE group were significantly higher than those in control group:(52.03±10.89)scores vs.(44.05±5.06)scores,(49.45±9.93)scores vs.(43.85±4.70)scores and(53.18±11.24)scores vs.(44.95±5.32)scores,and there were statistical differences(P<0.01).Multiple stepwise regression analysis result showed that inhibit inhibition,shift,emotional control,initiation,working memory,planning,organization,monitoring,MI and total score were correlated with disease control(P<0.01),and disease control had a negative predictive effect on them(R2=0.174,0.158,0.234,0.325,0.383,0.337,0.378,0.199,0.463 and 0.435);BRI was correlated with onset age and disease control(P<0.01 or<0.05),and onset age and disease control had a negative predictive effect on BRI(R2=0.336).Conclusions Children with CAE have ecological executive dysfunction.The control of the disease and the onset age are the main factors affecting the ecological executive function.

关 键 词：癫痫 失神性 儿童 生态学 执行功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]