托吡酯与传统抗癫痫药对新诊断癫痫患者认知影响的比较性研究

目的:比较托毗酯(TPM)与传统抗癫痫药(AEDs)对新诊断癫痫患者的认知功能影响。方法:采用随机对照及自身前后对照研究,分别给予新诊断癫痫患者TPM或传统AEDs(卡马西平、丙戊酸)单药治疗,于用药前及用药后6月运用韦氏成人智力量表(WAIS-CR)或韦氏儿童智力量表(WSIC—CR)、Stroop颜词干扰、倒背数(100-1)、1分钟名称数测试认知功能。结果:用药前神经心理学指标无统计学差异,用药后TPM组与传统AEDs组相比:总智商、数字广度得分下降(P值<0．01),言语智商、词汇得分下降(P值<0．05);TPM组用药前后相比总智商、言语智商、数字广度得分下降(P值<0．01)、词汇得分下降(P值<0．05)。Stroop读字时间延长(P值<0．01)、倒背数时间延长:(P值<0．05)。结论:小-中剂量托吡酯可造成患者较轻认知功能损害,主要表现在反应延迟,注意力涣散,语言理解力、流利性下降。

Comparative study on cognitive function in traditional antiepileptic drug and topiramate treatment for the patients with newly diagnosed epilepsy

Objective: To explore the effect on cognitive function in traditional antiepileptic drugs(AEDs) and topira-mate(TPM) treatment for the patients with newly diagnosed epilepsy. Methods: a prospective, randomized and controlled study and TPM group self-contrast study. 84 newly diagnosed epileptic patients were randomly divided into two mono-therapeutic groups: traditional AEDs(carbamazepine, valproic acid) group and TPM group. Receive the Wechesler adult intelligence scale (WAIS) or Wechsler intelligence scale for children(WlSC) ,the Stroop test, back-count(100-1) .vegetable names in a minute test at baseline and 6 months after starting medication, respectively. Result: After therapy the TPM group' s score of total IQ, the digital span were much lower than that of AEDs group(P<0. 01) and scores of Phrase were lower than that of AEDs group(P<0. 05). In TPM group the score of total IQ. verbal IQ and the digital span after 6 month were much lower than that in baseline(P<0. 01) . The scores of Phrase were declined(P<0. 05),the Stroop word-time extended(P<0. 01)and back -count time prolonged (P<0. 05). Conclusion: micro or moderately dosage of TPM monotherapy can result in cognitive imp irment in gently degree. The clinical manifestations are delayed reaction, declined attention , descended verbal perceptivity and fluency.