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投稿时间：2021-03-14 网络发布日期：2021-10-20
投稿时间：2021-03-14 网络发布日期：2021-10-20
中文摘要: 目的 探讨癫痫患儿共患认知障碍的发病特点，为癫痫患儿共患认知障碍的治疗提供参考依据。
方法 采用回顾性研究方法对2013年1月至2017年1月在唐山市妇幼保健院确诊的6至12岁癫痫患儿450例及同时间段6至12岁健康儿童50例（对照组）进行问卷调查。癫痫患儿依据调查结果分为癫痫组和癫痫共患组，利用蒙特利尔认知评估量表（MoCA）对所调查儿童进行认知功能评结，应用美国癫痫患者生活质量表（QOLIE-31）进行患儿生活质量问卷调查，依据评价结果对癫痫儿童共患认知障碍的临床特征及对生活质量影响进行分析。
结果 450例癫痫患儿中癫痫共患组178例，癫痫组272例。MoCA评分结果显示，三组组间比较，视空间与执行、注意力、语言功能、抽象能力、记忆力以及总分差异均有统计学意义（ P <0.05， P <0.01）；但局灶性发作、全面强直-阵挛发作、失神发作三种发作类型间比较，MoCA各项评分及总分差异无统计学意义（ P >0.05）。QOLIE-31评分结果显示，三组组间比较，社会功能、发作担忧、药物影响、生活满意度、精力状态、情绪状态、认知功能7项功能评分及总分差异均有统计学意义（ P <0.05， P <0.01）；三种发作类型间比较，除发作担忧和药物影响评分外，QOLIE-31大多评分结果差异无统计学意义（ P >0.05）。
结论 癫痫患儿具有较高共患认知障碍风险，共患认知障碍癫痫患儿发作类型不影响其认知障碍特征，共患认知障碍将严重影响患儿生活质量，应尽早进行治疗干预。
Abstract:Objective To explore the characteristics of comorbid cognitive impairment in children with epilepsy, and to provide reference basis for the treatment of comorbid cognitive impairment in children with epilepsy.
Methods A retrospective study was conducted on 450 children with epilepsy aged 6 to 12 years diagnosed in Tangshan Maternal and Child Health Hospital from January 2013 to January 2017. At the same time, 50 healthy children aged 6 to 12 years were selected as controls for questionnaire survey. According to the survey Results, children with epilepsy were divided into epilepsy group and epilepsy comorbid group. The cognitive function of the investigated children was evaluated by Montreal cognitive assessment scale (MoCA), and the childrens quality of life questionnaire was conducted by Quality of Life in PilePsy-31 (QOLIE-31). According to the evaluation Results, the clinical characteristics of comorbid cognitive impairment of children with epilepsy and its impact on quality of life were analyzed.
Results MoCA evaluation showed that among 450 children with epilepsy, 178 cases were in the epilepsy comorbidity group and 272 cases in the epilepsy group. MoCA score showed that there were significant differences in visual space and execution, attention, language function, abstract ability, memory, and total score among three groups （ P <0.05， P <0.01）； but there was no significant difference in the scores and total scores of MoCA among focal seizures, generalized tonic seizures and absence seizures（ P >0.05）. QOLIE-31 score Results showed that there were significant differences in social function, seizure worry, drug impact, life satisfaction, energy state, emotional state, cognitive function and total scores of 7 functions among three groups （ P <0.05， P <0.01）； but there was no significant difference in most of QOLIE-31 scores among the three seizure types except seizure worry and drug impact scores ( P >0.05).
Conclusions Children with epilepsy have a high risk of comorbid cognitive impairment. The seizure type of children with comorbid cognitive impairment does not affect the characteristics of cognitive impairment. Comorbid cognitive impairment will seriously affect the quality of life of children, so treatment and intervention should be carried out as soon as possible.
文章编号： 中图分类号： 文献标志码：B
基金项目:河北省医学科学研究重点课题计划（20181321）
引用文本：
张静，王玉珍，李树华，张润春，焦丽华，张双，刘寅，庞保东.癫痫患儿共患认知障碍的临床特征分析[J].中国临床研究,2021,34(10):1380-1383.
张静，王玉珍，李树华，张润春，焦丽华，张双，刘寅，庞保东.癫痫患儿共患认知障碍的临床特征分析[J].中国临床研究,2021,34(10):1380-1383.