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目的观察抗癫痫药物规范化治疗后,老年患者抑郁状态的变化。方法选择2011年1月1日~12月31日在台州市第一人民医院就诊的初诊或未曾规范化治疗的≥65岁的癫痫患者45例,男性19例,女性26例,收集患者基本资料及汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分,根据HAMD评分分为抑郁组14例,非抑郁组31例,患者进行规范化抗癫痫治疗,随访2年,再次评定HAMD评分,并收集相关资料。结果抑郁组患者治疗前HAMD评分[(21.14±3.66)分vs(12.19±3.00)分]及癫痫发作频率[(2.39±0.96)次/月vs(1.39±0.68)次/月]均明显高于非抑郁组(P=0.00)。2年正规用药后,抑郁组HAMD评分高于非抑郁组[(18.00±3.26)分vs(12.09±2.68)分,P=0.00],2组癫痫发作频率无显著差异[(0.05±0.12)次/月vs(0.07±0.18)次/月,P=0.73],抑郁组8例HAMD评分下降为正常(P<0.05),6例仍抑郁患者HAMD评分较治疗前下降,但无明显差异(P>0.05)。Spearman相关分析显示,治疗前HAMD评分及治疗前癫痫发作频率与抑郁改善呈正相关(r=0.77、0.55,P=0.00)。结论正规抗癫痫治疗能良好控制癫痫发作情况,并明显改善患者抑郁情绪,帮助恢复社会功能。治疗前癫痫发作越频繁,抑郁程度越重患者改善越明显。
Objective To observe the changes of depression status in elderly patients after standardized treatment of antiepileptic drugs. Methods 45 cases of epilepsy ≥65 years old, 19 males and 26 females were enrolled in the First People’s Hospital of Taizhou from January 1, 2011 to December 31, 2011. The basic data of patients and Hamilton depression scale (HAMD) score, according to HAMD score was divided into depression group of 14 cases, 31 cases of non-depression group, patients with standardized anti-epileptic treatment, followed up for 2 years, re-evaluation of HAMD score and collect relevant information. Results Before treatment, the HAMD score [(21.14 ± 3.66) vs (12.19 ± 3.00) points and seizure frequency [(2.39 ± 0.96) / month vs (1.39 ± 0.68) times / month were significantly higher in patients with depression Non-depression group (P = 0.00). After 2 years of formal medication, HAMD scores in depression group were significantly higher than those in non-depression group (18.00 ± 3.26 vs 12.09 ± 2.68, P = 0.00). There was no significant difference in seizure frequency between the two groups (0.05 ± 0.12) / Month vs (0.07 ± 0.18) times / month, P = 0.73]. HAMD scores of 8 patients in depression group decreased to normal (P <0.05). HAMD scores of 6 patients who were still depressed decreased compared with before treatment, but no significant difference > 0.05). Spearman correlation analysis showed that pre-treatment HAMD score and pre-treatment seizure frequency were positively correlated with improvement of depression (r = 0.77, 0.55, P = 0.00). Conclusion Formal anti-epileptic treatment can control the seizure condition well, and it can significantly improve depression and help restore social function. The more frequent seizures before treatment, the more severe the depression was and the more obvious the patients improved.