目的 对青少年肌阵挛癫痫(JME)患者的认知功能及心理精神状态进行评测,并探讨相关危险因素。方法 2011年9月至2014年2月21例JME患者作为患者组,同时选择18例年龄、性别及教育程度等与之相匹配的健康受试者作为对照组。采用蒙特利尔认知评估量表(MoCA)和中国成人韦氏智力量表(WAIS-RC)对认知功能进行评测;采用症状自评量表(SCL-90)对心理精神状态进行测试;采用Logistic回归分析其危险因素。结果 两组MoCA评分无显著性差异(t=-1.544, P=0.131)。患者组的语言智商、操作智商及全量表智商均显著低于对照组(t>4.119, P<0.001)。患者组SCL-90评分在人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执及精神病性7项高于对照组(t>2.480, P<0.05)。Logistic回归分析提示,服用丙戊酸的患者语言智商下降(B=-3.064, OR=0.047, 95%CI=0.002~0.920, P=0.044)。结论 JME患者的语言智商、操作智商及全量表智商下降,在人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执及精神病性症状方面存在不同程度的障碍。服用丙戊酸是JME患者认知功能下降的危险因素。
Objective To investigate the cognitive function and psychological mental state of patients with juvenile myoclonic epilepsy (JME), and the related risk factors. Methods From September, 2011 to Febrary, 2014, 21 patients with JME and 18 healthy controls matched with age, sex and educational level were assessed with Montreal Cognitive Assessment (MoCA), and Revised Chinese Wechsler Adult Intelligence Scale (WAIS-RC) and Symptom Checklist-90 (SCL-90). The risk factors were analyzed with Logistic regression analysis. Results There was no significant difference in the score of MoCA between two groups (t=-1.544, P=0.131). The scores of verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full intelligence quotient (FIQ) in WAIS-RC were significantly lower in the patient group than in the control group (t>4.119, P<0.001). The scores of interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism in SCL-90 were significantly higher in the patient group than in the control group (t>2.480, P<0.05). Logistic regression analysis showed that VIQ significantly decreased in patients taking valproic acid (B=-3.064, OR=0.047, 95% CI=0.002~0.920, P=0.044). Conclusion VIQ, PIQ and FIQ decreased in patients with JME. Furthermore, different levels of dysfunction were found in interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Taking valproic acid was the risk factor of cognitive decline.
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