癫痫患儿治疗后认知功能的影响因素  

Influencing factors of post-treatment cognitive function in children with epilepsy

作　　者：黄雪林 陈晓兰[2] 阮毅燕[1] 韩蕴丽[2] HUANG Xue-lin;CHEN Xiao-lan;RUAN Yi-yan;HAN Yun-li(Department of Pediatric Neurology,the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Guangxi Clinical Center for Pediatric Diseases Research,Nanning 530002,China;Department of Pediatric Neurology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西壮族自治区妇幼保健院、广西儿科疾病临床研究中心儿童神经内科,南宁市530002 [2]广西医科大学第一附属医院儿童神经内科,南宁市530021

出　　处：《广西医学》2022年第5期469-473,共5页Guangxi Medical Journal

基　　金：广西科技计划(桂科AB17195011);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180087)。

摘　　要：目的分析癫痫患儿治疗后认知功能的影响因素。方法回顾性分析1个月至6岁的97例癫痫患儿(确诊时Gesell发育量表评分正常)的临床资料。根据治疗12个月后Gesell发育量表评分将患儿分为观察组(Gesell发育量表评分异常,n=37)和对照组(Gesell发育量表评分正常,n=60)。比较两组患儿的临床资料,并采用多因素Logistic回归模型分析癫痫患儿治疗后认知功能的影响因素。结果与对照组相比,观察组患儿的发病年龄较小,确诊时语言行为发育商和个人-社交行为发育商更低(均P<0.05);两组的用药方案差异亦有统计学意义(P<0.05),其中观察组联合治疗的比例更高。多因素Logistic回归分析提示,治疗12个月后,发病年龄≥18个月患儿认知功能正常的概率是发病年龄≤6个月患儿的12.839倍,语言行为发育商>93患儿认知功能正常的概率是语言行为发育商≤93患儿的4.596倍,使用联合治疗的患儿认知功能正常的概率是使用丙戊酸钠单药治疗患儿的0.098倍(均P<0.05)。结论发病年龄小、确诊时语言行为发育商低的癫痫患儿治疗后认知功能异常的可能性更大。Objective To analyze the influencing factors of post-treatment cognitive function in children with epilepsy.Methods The clinical data of 97 children with epilepsy aged one month to six years(with normal Gesell Developmental Schedules[GDS]scores at definite diagnosis)were analyzed retrospectively.According to the GDS scores after 12 months of the treatment,the children were divided into observation group(with abnormal GDS scores,n=37)and control group(with normal GDS scores,n=60).The clinical data of the children were compared between the two groups,and the multivariate Logistic regression model was employed to analyze influencing factors of post-treatment cognitive function in children with epilepsy.Results Compared with the control group,children in the observation group were younger at disease onset and had lower developmental quotients for verbal behaviors and personal-social behaviors at definite diagnosis(all P<0.05);there were statistically significant differences between the medication regimens of the two groups(P<0.05),and the observation group exhibited a higher proportion of cases receiving combination therapy.Multivariate Logistic regression analysis revealed that,after 12 months of the treatment,children with onset age≥18 months had a 12.839 times greater probability to have a normal cognitive function than those with onset age≤six months;children with developmental quotients for verbal behaviors>93 had a 4.596 times greater probability to have a normal cognitive function than those with developmental quotients for verbal behaviors≤93,and children receiving the combination therapy harbored a 0.098 time greater probability to have a normal cognitive function than those receiving monotherapy of sodium valproate(all P<0.05).Conclusion Children with low onset age or developmental quotients for verbal behaviors at definite diagnosis might have a greater probability to suffer from cognitive dysfunction after the treatment.

关 键 词：癫痫 儿童 认知功能 GESELL发育量表 影响因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]