外伤后癫痫患者认知损害的影响因素分析  

Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy

作　　者：胡旭 董吉荣[1] 徐凤 孙诗白 徐小梅 王玉海[1] HU Xu;DONG Jirong;XU Feng;SUN Shibai;XU Xiaomei;WANG Yuhai(Department of Neurosurgery,904th Hospital of PLA,Wuxi 214044,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院(原解放军第101医院)神经外科,无锡214044

出　　处：《癫痫杂志》2023年第1期26-32,共7页Journal of Epilepsy

摘　　要：目的分析外伤后癫痫患者的认知损害的影响因素。方法回顾性分析2016年1月—2019年1月于中国人民解放军联勤保障部队第904医院神经外科外伤后癫痫(癫痫组)患者45例、健康体检(对照组)患者48例,采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简明精神状态量表(Mini-mental state examination,MMSE)、听觉词语记忆测验(Audio verbal memory test,AVMT)、Rey-Osterrieth复杂图形测验(Complex figure test,CFT)、连线测验(Trail making test,TMT)进行认知评估。并分析外伤后癫痫患者的性别、年龄、病程、损伤原因、类型、程度及部位,发作频率及抗癫痫发作药物(Anti-seizure medications,ASMs)对认知损害的影响。结果分析结果显示,所有量表癫痫组与对照组对比均具有统计学差异(P<0.01)。癫痫组的影响因素分析:(1)MoCA及MMSE评分:发作频率及损伤程度组内对比具有统计学差异(P<0.05);(2)AVMT、CFT及TMT评分:发作频率、损伤程度及部位、ASMs组内对比具有统计学差异(P<0.05)。结论外伤后癫痫可引起患者的认知功能损害,癫痫发作频率较高及外伤损伤程度较重的患者对认知的损害越为严重。损伤部位的不同影响认知损害的范围,颞部损伤易引起记忆功能下降;额部损伤易引起空间结构和执行能力下降,同时,联合使用ASMs对认知功能存在影响。Objective To analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy.Methods From January 2016 to January 2019,45 patients with Post-traumatic epilepsy(epilepsy group)and 48patients with physical examination(control group)at the Department of Neurosurgery,the 904th Hospital of PLA were analyzed retrospectively.Cognitive assessment using the following scales:Montreal cognitive assessment(MoCA),Minimental state examination(MMSE),Audio verbal memory test(AVMT),Rey-osterrieth complex figure test(CFT)and Trail making test(TMT).To analyze the gender,age,course of disease,cause,type,degree and location of injury,seizure frequency and Anti-seizure medications(ASMs)on cognitive impairment.Results The results showed that there was significant difference between the epilepsy group and the control group(P<0.01).Analysis of influencing factors in epilepsy group:(1)MoCA and MMSE scores:there was statistical significance in the comparison of seizure frequency and injury degree(P<0.05);(2)AVMT,CFT and TMT scores:there was statistical significance in the comparison of seizure frequency,injury degree and location,ASMs within the group(P<0.05).Conclusion Post-traumatic epilepsy can cause cognitive impairment.The more frequent epileptic seizures and the more severe the degree of trauma,the more serious the cognitive impairment.Different injury sites affect the scope of cognitive impairment,temporal lobe injury is easy to cause memory function decline,frontal lobe injury is easy to cause spatial structure and executive ability decline,at the same time,the combined use of ASMs has an impact on cognitive function.

关 键 词：外伤后癫痫 认知障碍 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]