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目的探讨拉莫三嗪(LTG)和丙戊酸钠(VPA)对癫儿童认知功能的影响。方法首次确诊的癫患儿76例中,36例用LTG单药治疗,40例用VAP单药治疗。用药6个月前后对二组进行智力(IQ)测定。同时选取20例健康儿童作为健康对照组。结果1.癫患儿语言智商(VIQ)、操作智商(PIQ)和总智商(FIQ)明显低于健康对照组,各项分测验得分亦均降低(Pa<0.05)。2.癫患儿用LTG治疗6个月后VIQ、PIQ、FIQ及各项分测验得分较用药前无明显变化(Pa>0.05);癫患儿用VPA治疗6个月后VIQ、PIQ、FIQ无明显变化(Pa>0.05),而在分测验中知识项得分用药后比用药前显著提高(P<0.05),编码、木块图项得分显著下降(Pa<0.05)。结论癫患儿易发生认知功能损害,且损害无选择性;癫患儿服用LTG6个月后对认知功能无影响;服用VPA6个月后FIQ未见明显变化,但在木块图和编码上有降低,而在知识项得分用药后比用药前提高,表明VPA主要影响右脑功能,而对左脑无影响。
Objective To investigate the effects of lamotrigine (LTG) and valproate (VPA) on cognitive function in epileptic children. Methods Of the 76 patients with epilepsy diagnosed for the first time, 36 were treated with LTG monotherapy and 40 were treated with VAP monotherapy. Six months before and after treatment of two groups of intelligence (IQ) determination. At the same time, 20 healthy children were selected as healthy control group. The results showed that the scores of VIQ, PIQ and FIQ in epileptic children were significantly lower than those in healthy controls (P <0.05). There was no significant change in VIQ, PIQ, FIQ and other sub-test scores before treatment in children with epilepsy after 6 months of treatment with LTG (P> 0.05). VIQ, PIQ (P> 0.05). However, in the sub-test, the score of knowledge items significantly increased (P <0.05) and the score of code and block figure decreased significantly (P <0.05). Conclusions Children with epilepsy are prone to have cognitive impairment and no selective damage. Children with epilepsy have no effect on cognitive function after taking LTG for 6 months. There is no obvious change in FIQ after taking VPA for 6 months, And coding decreased, but in the knowledge items after medication than before medication increased, indicating that VPA mainly affects the right brain function, while no effect on the left brain.