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目的评价拉莫三嗪对癫癎患者认知功能以及生活质量的影响。方法对91例新诊断的癫癎患者给予拉莫三嗪治疗,并在用药前及用药16周后进行认知功能评定及生活质量调查。认知功能评定工具包括听觉词语测验、逻辑记忆测验、数字符号转换测验、Stroop 字色干扰测验、连线测验、言语流畅性测验、韦氏积木测验、数字广度测验及 Boston 命名测验;生活质量调查采用患者生活质量评定量表-31(QOLIE-31)。结果癫癎患者应用拉莫三嗪治疗16周后与用药前比较,各项得分均有提高,其中以即刻与延迟词语记忆、情景记忆、执行功能、空间知觉能力以及言语命名功能方面改善显著。生活质量方面,QOLIE-31量表的7个测评方面及1个总体健康评价中,6项分值在用药后较用药前有所提高,其中“对癫癎的担心”(38.81±16.06,16周后45.68±15.18,P<0.01)、“总体生活质量”(59.12±13.50,16周后64.99±13.33,P<0.01)、“社会功能”(64.59±25.14,16周后69.41±22.70,P<0.05)以及“总体自身健康评价”(71.18±13.73,16周后76.75±11.30,P<0.01)4项的得分差异有统计学意义。结论拉莫三嗪单药治疗新诊断癫癎患者可在短期内改善其认知功能,并提高生活质量。
Objective To evaluate the effect of lamotrigine on cognitive function and quality of life in patients with epilepsy. Methods Ninety-one patients with newly diagnosed epilepsy were given lamotrigine and cognitive function assessment and quality of life test were performed before treatment and 16 weeks after treatment. Cognitive function assessment tools include auditory words test, logical memory test, digital sign conversion test, Stroop color interference test, connection test, speech fluency test, Webster block test, digital breadth test and Boston naming test; quality of life survey Patient Quality of Life Rating Scale-31 (QOLIE-31) was used. Results After treatment with lamotrigine for 16 weeks in epileptic patients, the scores of all subjects were improved after treatment. The scores of immediate and delayed words memory, situation memory, executive function, spatial perception ability and speech naming function improved significantly. Quality of life, QOLIE-31 scale of the seven evaluation aspects and an overall health evaluation, six scores after treatment than before treatment has improved, including “worry about epilepsy” (38.81 ± 16.06 , 45.68 ± 15.18 after 16 weeks, P <0.01), “overall quality of life” (59.12 ± 13.50, 64.99 ± 13.33, P <0.01 after 16 weeks), “social function” (64.59 ± 25.14, 16 weeks (69.41 ± 22.70, P <0.05), and the score of “Overall Self-health Evaluation” (71.18 ± 13.73, 76.75 ± 11.30, P <0.01 after 16 weeks) was statistically significant. Conclusions Lamotrigine monotherapy can improve cognitive function and improve quality of life in newly diagnosed epilepsy patients in a short period of time.