改良生酮饮食添加治疗难治性癫痫并发认知障碍患者的疗效  

Efficacy of modified ketogenic diet addition in the treatment of patients with refractory epilepsy complicated with cognitive disorder

作　　者：杜涛涛 毕锦玉 雒晨宇 孙美珍[1] Du Taotao;Bi Jinyu;Luo Chenyu;Sun Meizhen(Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学,山西太原030000

出　　处：《实用药物与临床》2024年第7期531-535,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨改良生酮饮食——中链甘油三酯饮食(Medium chain triglyceride diet,MCTD)添加治疗难治性癫痫并发认知障碍患者的疗效。方法回顾性收集山西医科大学第一医院神经内科门诊及住院部2021年11月至2022年11月难治性癫痫并发认知障碍患者的临床资料,比较MCTD添加治疗前及治疗后3个月癫痫发作频率、1 h视频脑电图、蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)量表(≥16岁)及韦氏智力量表(6~15岁)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)的变化,评估其疗效。结果①接受MCTD治疗的19例患者中,癫痫发作控制治疗有效率为84.21%。②MCTD治疗后,≥16岁患者中,MoCA量表评分升高(Z=3.007,P=0.002);6~15岁患者中,韦氏智力量表评分升高(Z=2.371,P=0.018)。③伴有焦虑抑郁的患者中,MCTD治疗后,HAMA、HAMD评分降低(Z_(焦虑)=2.67,P_(焦虑)=0.008;Z_(抑郁)=2.809,P_(抑郁)=0.005)。共3例患者退出研究,退出原因有依从性差、经济紧张。结论MCTD可作为难治性癫痫共病认知障碍患者的一项安全、有效的添加治疗方案。Objective To investigate the efficacy of modified ketogenic diet-medium chain triglyceride diet(MCTD)addition in the treatment of patients with refractory epilepsy complicated with cognitive disorder.Methods The clinical data of patients with refractory epilepsy complicated with cognitive disorder in the Department of Neurolo gy of the First Hospital of Shanxi Medical University from November 2021 to November 2022 was collected,and the seizure frequency,1 hour video electroencephalogram,MoCA scale(≥16 years)and Wechsler intelligence scale(6~15 years),Hamilton anxiety scale,and Hamilton depression scale before and 3 months after MCTD treatment were compared.The efficacy was assessed.Results①In 19 patients treated with MCTD,the effective rate of seizure control treatment was 84.21%.②After MCTD treatment,the score of MoCA scale in patients aged≥16 years was increased(Z=3.007,P=0.002),the score of Wechsler intelligence scale in patients aged 6~15 years was increased(Z=2.371,P=0.018).③After MCTD treatment,the HAMA and MAMD scores of patients with anxiety and depression were decreased(Z_(anxiety)=2.67,P_(anxiety)=0.008;Z_(depression)=2.809,P_(depression)=0.005).There were 3 patients who dropped from the study,and the reasons for it included poor compliance and economic burden.Conclusion MCTD can be a safe and effective addition treatment option for patients with refractory epilepsy complicated with cognitive disorder.

关 键 词：中链甘油三酯饮食 难治性癫痫 认知障碍 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]