摘要
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。
Objective： To explore the effect on cognitive function in traditional antiepileptic drugs（AEDs） and topiramate（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 monotherapeutic g.roups： traditional AEDs（carbamazepine, valproic acid） group and TPM group. Receive the Wechesler adult intelligence scale （WAIS） or Wechsler intelligence scale for children（W1SC）, 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.
出处
《脑与神经疾病杂志》
2007年第2期126-129,共4页
Journal of Brain and Nervous Diseases
关键词
癫痫
托吡酯
传统抗癫痫药
认知功能
药效
epilepsy topiramate traditional antiepileptic-drugs cognitive function
