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目的分析癫痫患者执行功能损害的特点及相关影响因素。方法1999年1月～2006年4月在我院癫痫专病门诊就诊或长期随访的109例成年癫痫患者和75例正常对照者进行神经认知心理测验,包括语义流畅性试验、数字广度测验、数字符号测验、色词干扰测验和连线试验检查。结果癫痫患者组语义流畅性显著差于正常对照组,数字广度、数字符号亦显著低于正常对照组,癫痫组连线时间、Stroop试验反应时显著延长,Stroop试验错误数显著增加(P<0.01)。颞叶癫痫患者数字广度低于额叶癫痫患者。多元线性回归显示:文化程度高、非颞叶癫痫对语义流畅性有保护作用;文化程度高、单一抗癫痫药物治疗、病程短、年龄大对数字广度有保护作用;病程短、文化程度高和颅内无病灶对数字符号有保护作用。结论癫痫患者在多项执行功能方面均存在损害,文化程度高的患者执行功能相对较好;颞叶癫痫患者语义流畅性差;病程、药物、年龄对数字广度有影响;病程、有无病灶对数字符号有影响。
Objective To analyze the characteristics of executive dysfunction in patients with epilepsy and related factors. Methods From January 1999 to April 2006, 109 cases of adult epilepsy and 75 normal controls were investigated in our epilepsy outpatient clinic or long-term follow-up. The neurocognitive and psychological tests were conducted, including semantic fluency test, digital breadth test, Digital symbol test, color word interference test and connection test. Results The semantic flu of epilepsy patients was significantly lower than that of normal control group. The digit width and number sign were significantly lower than those of normal control group. The connection time of epilepsy group was significantly longer in response to Stroop test and the errors of Stroop test were significantly increased (P <0.01 ). Patients with temporal lobe epilepsy have a lower breadth than patients with frontal lobe epilepsy. Multivariate linear regression showed that high education level and non-temporal epilepsy had protective effect on semantic fluency; high educational level, single antiepileptic drug treatment, short course of disease and large age had protective effect on digital breadth; short course of disease, high education and No intracranial lesions have a protective effect on the digital sign. Conclusions Patients with epilepsy have impairment in multiple executive functions. Patients with high education level perform relatively well; patients with temporal lobe epilepsy have poor semantic flu; duration of illness, drugs and age have an impact on the number of patients; Symbols have an impact.