抗癫痫药物对癫痫患者认知功能障碍影响的研究

目的研究和探讨3种抗癫痫药对癫痫患者认知功能的影响。方法收集湛江中心人民医院神经内科门诊和住院的癫痫患者320例,正常对照组30例。患者按照不同服药情况分别分为3组单药服药组和3组联合服药组分别进行韦氏智能测定,然后进行统计分析。结果320例癫痫患者中,智能水平低于正常者（IQ值〈90分）259例（80.9%）,智能水平明显低下者（IQ值〈70分）168例（52.8%）。秩和检验结果显示单药服药组之间的认知水平无显著差异,但联合用药组的认知水平较单药服药组以及正常组低下（P〈0.05）,丙戊酸钠＋妥泰＋卡马西平组的认知功能水平最低。线性回归结果显示患者职业、文化程度、病程、发作次数以及是否存在脑部继发性疾病等则对患者的认知功能影响显著。相关分析显示认知功能水平与患者的焦虑抑郁情感评分呈显著负相关,与患者的情绪、精力、认知功能、用药顾虑显著相关,而患者的焦虑抑郁情绪与其情绪、精力、认知功能显著相关。结论抗癫痫药可造成癫痫患者认知功能的损害,单药应用认知功能损害较轻,联合用药对癫痫患者认知功能损害严重。研究提示尽量单药、足量、足疗程、合理用药原则,避免联合用药。

The Research of the Different Type Epilepsy Medicine on the Influence of Cognitive Function Impairment with Epilepsy Patients

Objecteve Study and probe into the different type epilepsy medicine on the influence of cognitive function impairment with epilepsy patients.Methods Collected 320 cases epilepsy patients in hospital and 56 cases contrast normally in People s Hospital of the centre of Zhanjiang,and Carry on the determine of the cognitive function separately,then carry on statistical analysis.Results In 320 cases with epilepsy patients,259 cases persons who has intellectual Impairment（80.9%）（IQ〈90）,168 cases has seriously intellectual Impairment（52.8%）（IQ〈70）. Both group cognitive impairment there are significance differences in normal group and the epilepsy patients. There is not remarkable difference in cognitive level and anxious depressed emotion on the single anti--epilepsy drugs of the three groups, but both and three anti--epilepsy medicines therapeutic alliance might induced the severity cognitive impairment with epilepsy patients. Regression analysis result, the main influence factor of the cognitive impairment is education and job, the influence of the age and sex is not remarkable. The profession, education, course of disease, episode frequency and secondary encephalopathy disease are remarkable influence on the cognitive impairment. Relevant analysis shows that the cognitive function level have remarkable correlation with the patient＇s mood, stamina, cognitive function, worry of using medicine. Conclusion The anti--epilepsy drugs can induced severity cognitive function impairment with epilepsy patients, the anti--epilepsy medicines therapeutic alliance can induced maximum impairment on the cognitive function with epilepsy patients. It is important that try one＇s best single medicine, enough capacity drugs, sufficient course of treatment, avoid the anti--epilepsy medicines therapeutic alliance.