文章摘要
许 虹,张明之,龙发青,聂 荔,郭 春.托吡酯和丙戊酸钠缓释片对成年癫疒患者认知功能的影响[J].南京医科大学学报,2008,28(12):1587~1590
托吡酯和丙戊酸钠缓释片对成年癫疒患者认知功能的影响
The effects of topiramate and sodium valproate retard tablet on cognitive function in adult with epilepsy
投稿时间:2008-07-03  
DOI:10.7655
中文关键词: 托吡酯片  丙戊酸钠缓释片  癫■  认知功能
英文关键词: topiramate tablet  sodium valproate retard tablet  epilepsy  cognitive function
基金项目:
作者单位
许 虹 昆明医学院第一附属医院神经内科,云南 昆明 650032 
张明之  
龙发青  
聂 荔  
郭 春  
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中文摘要:
      评价托吡酯(topiramate tablet,TPM)与丙戊酸钠缓释片(sodium valproate retard tablet,VAP)对成年癫■患者认知功能的影响?方法:62例新确诊成年癫■患者随机分为2组,TPM组(30例)与VAP组(32例);采用自身对照研究分别于用药前及用药2个月后采用韦氏修订记忆量表(WMS-RC)与P300检查对癫■患者的认知功能做出评估?结果:①服药前TPM组VAP组比较记忆商值(MQ)?ERPs检查中P3波潜伏时间P > 0.05,2组间认知功能无明显差异;②TPM组较服药前1→100顺序数数分值下降?100→1倒数水平降低?数字累加分值降低?图片再认错误增加?图片记忆能力降低?图像再生错误率增加?词语联想错误增多?实物触摸困难?故事理解能力降低?顺背反背数字难度增大;ERPs 检查中,N1波潜伏时间延长,P2?N2?P3波潜伏时间均明显延长,P3波波幅降低?VAP组WMS-RC测试各分项分值较用药前无显著变化;ERPs 检查中,N1波潜伏时间缩短,P2?N2?P3波潜伏时间均缩短明显,P3波幅增高不明显;③WMS-RC中的短期记忆与P3波潜伏时间呈负相关?结论:TPM在加量阶段可以引起癫■患者认知功能障碍;VAP对癫■患者的认知功能有改善作用;将P300与WMS-RC结合用于癫■患者认知功能评估,其结果更客观?全面?
英文摘要:
      Objective:To evaluate the effects of topiramate(TPM) and sodium valproate retard tablet(VAP) on cognitive function in adult patients with epilepsy. Methods:Sixty-two adult patients,newly diagnosed as epilepsy,were randomly divided into 2 groups:TPM Group(n = 30) and VAP Group(n = 32). The cognitive function of all the patients in these two groups were evaluated by the Revised Adult Wechsler memory scale(WMS-RC) and event related potentials(ERPs) before treatment and after two months administration of TPM/VAP. Results:①Before administration of TPM:Memory Quotient(MQ) < 100,accounting for 26.67%;In the ERPs,the P3 wave latency >359.9ms,accounting for 33.33%. Before administration of VAP:MQ < 100,accounting for 28.0%;In the ERPs,the P3 wave latency > 359.9ms,accounting for 31.25%. There was not significant difference between these two groups with respect to the cognitive function(P > 0.05). ②After administration of TPM,in TPM Group the score of sequence counts of 1 to 100 declined(P < 0.01),the score of sequence counts of 100 to1 declined(P < 0.05), the score of digit cumulate cognitive function declined(P < 0.05),the mistakes of cards recognition increased(P < 0.01), the function of cards remembrance declined(P <0.01), the mistakes of cards reclamation increased(P < 0.01),the mistakes of word association increased(P < 0.01), the object touch was more difficult(P < 0.01), the function of story apprehension declined(P < 0.01)and the natural order and anti- natural order repeat of digit were more difficult(P < 0.01). In the ERPs, the N1 wave latency prolonged(P < 0.05) and the P2,N2 and P3 waves latencies all prolonged significantly(P < 0.01),while the amplitude of P3 wave declined(P < 0.01). After administration of VAP,in VAP Group:the score of WMS-RC TEST in every item did not change significantly(P > 0.05). In the ERPs,the N1 wave latency shortened(P < 0.05) and the P2,N2 and P3 waves latencies all shortened significantly(P < 0.01),while the amplitude of P3 wave did not increase significantly(P > 0.05). ③The transient memory of WMS-RC was reversely correlated with the P3 wave latency(P < 0.05). Conclusion:After administrateration of TPM,patients with epilepsy who were in the drug titration phase were more likely to suffer from many cognitive disturbers;Patients’ cognitions were improved by administration of VAP;After examination of ERPs and WMS-RC ,the results of evaluation of cognitive function will be more objective and comprehensive.
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