颞叶癫痫患者执行功能特点及其与影响因素相关分析  

Analysis of executive function characteristics and its influencing factors in temporal lobe epilepsy patients

作　　者：杨娟 毓青[2] 姚晓娟[2] 杨卫东[3] 陈旨娟[3] YANG Juan;YU Qing;YAO Xiao-juan;YANG Wei-dong;CHEN Zhi-juan(Department of Neurology,China Resources&WISCO General Hospital,Wuhan 430080,Hubei,China;Department of Neurology,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Neurosurgery,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]华润武钢总医院神经内科,武汉430080 [2]天津医科大学总医院神经内科,300052 [3]天津医科大学总医院神经外科,300052

出　　处：《中国现代神经疾病杂志》2022年第7期578-585,共8页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的探讨颞叶癫痫(TLE)患者执行功能特点并分析其与神经心理学测验之间相关性。方法纳入2017年6月至2018年12月天津医科大学总医院与华润武钢总医院诊治的25例颞叶癫痫患者,其中左侧颞叶癫痫8例(LTLE组)、右侧颞叶癫痫17例(RTLE组),分别行神经心理学测验和执行功能测验;Pearson相关分析和偏相关分析探讨执行功能与各项影响因素的相关性,多因素线性逐步回归分析验证二者线性数量关系。结果LTLE组、RTLE组与对照组受试者简易智能状态检查量表(MMSE)评分(P=0.003),数字工作记忆评分(P=0.000)和言语工作记忆评分(P=0.000),颜色反应时间(P=0.001)、词汇反应时间(P=0.009)和色词反应时间(P=0.001),连线测验A和B部分(TMT-A和TMT-B)时间(P=0.010,0.009),词汇流畅性测验(VFT)个数(P=0.000)差异均有统计学意义;其中,LTLE组和RTLE组MMSE评分(P=0.013,0.029)、数字工作记忆评分(P=0.000,0.000)、言语工作记忆评分(P=0.000,0.000)和VFT个数(P=0.000,0.000)低于对照组,颜色反应时间(P=0.047,0.000)、词汇反应时间(P=0.002,0.006)和色词反应时间(P=0.024,0.001)长于对照组,仅RTLE组TMT-A时间(P=0.004)和TMT-B时间(P=0.002)长于对照组。相关分析显示,数字工作记忆评分、颜色反应时间、词汇反应时间、转移注意时间与MMSE评分、汉密尔顿焦虑量表(HAMA)评分、Beck抑郁量表(BDI)评分、年龄、受教育程度、癫痫发作频率、抗癫痫药物种类呈正相关(P<0.05或P<0.01),TMT-A时间、TMT-B时间与MMSE评分、HAMA评分、年龄、受教育程度、癫痫发作频率、抗癫痫药物种类呈正相关(P<0.05或P<0.01),色词反应时间、VFT个数与HAMA评分、年龄、受教育程度呈正相关(P<0.05或P<0.01)。多因素线性逐步回归分析显示,数字工作记忆评分与癫痫发作频率(标准化偏回归系数=0.998,P=0.001)和抗癫痫药物种类(标准化偏回归系数=-1.634,P=0.006),言语工作记忆评分与HAMA评分(标准化偏�ObjectiveTo investigate the characteristics of temporal lobe epilepsy(TLE)executivefunction and its correlation with neuropsychological tests.MethodsA total of 25 patients with TLE[including 8 patients with left TLE(LTLE)and 17 patients with right TLE(RTLE)]and 15 healthy controlswith matched sex,age and education level admitted to Tianjin Medical University General Hospital andChina Resources&WISCO General Hospital from June 2017 to December 2018 were enrolled.Neuropsychological tests[including Mini-Mental State Examination(MMSE),Hamilton Anxiety RatingScale(HAMA),Beck Depression Inventory(BDI)]and executive function tests[including digital workingmemory,verbal working memory,Stroop Color-Word Test(SCWT),Trail Making Test-A and B(TMT-A andTMT-B),and Verbal Fluency Test(VFT)]were performed.Pearson correlation analysis and partialcorrelation analysis were used to explore the correlation between executive function and various factors,andmultiple linear stepwise regression analysis was used to verify the linear quantitative relationship betweenexecutive function and various factors.ResultsMMSE score(P=0.003),digital working memory score(P=0.000),verbal working memory score(P=0.000),color response time(P=0.001),word response time(P=0.001),color word response time(P=0.001),TMT-A time(P=0.010),TMT-B time(P=0.009)and thenumber of VFT(P=0.000)of LTLE group,RTLE group and control group were significantly different.MMSE score(P=0.013,0.029),digital working memory score(P=0.000,0.000),verbal working memoryscore(P=0.000,0.000)and the number of VFT(P=0.000,0.000)in LTLE group and RTLE group werelower than those in control group.Color response time(P=0.047,0.000),word response time(P=0.002,0.006)and color word response time(P=0.024,0.001)were longer than those in control group,but TMT-Atime(P=0.004)and TMT-B time(P=0.002)in RTLE group were longer than those in control group.Therewere no significant differences in executive function scores between LTLE group and RTLE group(P>0.05,for all).Correlation analysis showed that digita

关 键 词：癫痫 颞叶 认知障碍 神经心理学测验 

分 类 号：R742.1[医药卫生—神经病学与精神病学]