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目的探讨发作间期样放电(IEDs)对癫患者认知功能的影响。方法选取6个月内无临床发作的癫患者164例,随访2年(脱落96例,剔除癫发作12例,脑电图改变4例),共计收集52例为研究对象,其中有IEDs癫36例为IED组;无IED癫16例为无IED组。于随访2年前后分别完成24 h动态脑电图及认知功能评定。IED组根据清醒期有无IED分为清醒期IED亚组和清醒期无IED亚组。采用简易精神状态量表(MMSE),ADDENBROOKE’S认知功能检查中文版(ACE-R),短延时词语记忆[AVLT(N4)及连线测试(TMT)]评价各组癫患者的认知功能情况。结果随访前:IED组MMSE、ACE-R,AVLT(N4)及TMT与无IED组比较,均差异无显著性。随访2年后:IED组认知功能评分、ACE-R总分、语言和记忆分值均较无IED组下降,差异有统计学意义(P<0.05);IED组TMT-B延长值与无IED组比较,差异有统计学意义(P<0.05)。清醒期IED组和清醒期无IED组认知功能测试差异无显著性。结论 IEDs是导致癫患者认知功能下降的原因之一,主要表现在语言、记忆、执行功能。未发现清醒期IEDs与癫患者的认知功能相关。
Objective To investigate the effect of interictal discharges (IEDs) on cognitive function in patients with epilepsy. Methods Sixty-four patients with epilepsy without clinical seizures within 6 months were selected and followed up for 2 years (96 cases of exfoliation, 12 cases of epileptic seizures excluding epilepsy and 4 cases of changes of electroencephalogram). A total of 52 cases were selected as the study subjects, including IEDs Epilepsy 36 cases of IED group; no IED epilepsy 16 cases of IED group. The 24-hour dynamic electroencephalogram and cognitive function were assessed at 2 years after follow-up. According to the IED group, IED group was divided into awake IED group and awake IED group. The cognition of epileptic patients in each group was evaluated by MMSE, ADDENBROOKE’S Chinese version of cognitive function test (ACE-R), short latency words memory [AVLT (N4) and connection test (TMT) Functional situation. Results Before the follow-up, MMSE, ACE-R, AVLT (N4) and TMT in IED group were not significantly different from those in IED group. After 2 years of follow-up, the scores of cognitive function, ACE-R score, language and memory in IED group were significantly lower than those in non-IED group (P <0.05) IED group, the difference was statistically significant (P <0.05). There was no significant difference in cognitive function test between awake IED group and awake IED group. Conclusion IEDs is one of the reasons leading to the decline of cognitive function in patients with epilepsy, mainly in language, memory and executive function. No suturing IEDs were found to be associated with cognitive function in patients with epilepsy.