颞叶癫痫患者海马硬化与认知障碍的相关性分析

发布时间：2018-06-24 16:14

本文选题：颞叶癫痫 + 海马硬化　；参考：《中风与神经疾病杂志》2017年12期

【摘要】：目的探讨颞叶癫痫(temporal lobe epilepsy,TLE)患者海马硬化(hippocampal sclerosis,HS)与认知障碍的关系。方法采集TLE患者起病年龄、病程、有无高热惊厥史、有无全面强直阵挛发作(generalized tonic clonic seizure,GTCS)等相关病史,行海马氢离子磁共振波谱成像(~1H-Magnetic resonance spectroscopy,1H-MRS)分析海马组织细胞N-乙酰天门冬氨酸(NAA)、胆碱(Cho)及肌酸(Cr)浓度,计算NAA/(Cho+Cr)值,并运用《中国修订版韦氏成人智力量表》和《中国修订版韦氏成人记忆量表》对认知功能进行评测,分析HS与认知障碍的关系。结果起病年龄越小、病程越长,有高热惊厥史、有GTCS发作等因素的患者海马NAA/(Cho+Cr)值更低,认知障碍更严重(P0.05);伴HS的TLE患者比不伴HS的TLE患者认知障碍严重,且两者较正常人严重(P0.05);HS患者海马NAA/(Cho+Cr)值下降程度与认知障碍程度有明显相关性(P0.05)。结论 TLE患者起病年龄、病程、高热惊厥史、GTCS发作等病史与认知障碍相关;对TLE患者行海马~1H-MRS检查有助于早期评估及发现认知障碍,为临床合理选择抗癫痫药物、添加改善认知障碍药物、改善患者生活质量提供依据。
[Abstract]:Objective to investigate the relationship between hippocampal sclerosis (hippocampal sclerosis HS) and cognitive impairment in patients with temporal lobe epilepsy (temporal lobe epilepsyn TLE). Methods the onset age, course of disease, history of febrile convulsion and (generalized tonic clonic seizureus were collected. The concentrations of N-acetylaspartate (NAA), choline (Cho) and creatine (Cr) in hippocampal tissue cells were analyzed by 1H-magnetic resonance spectroscopy (1H-MRS) and NAA / (Cho Cr) values were calculated. The relationship between HS and cognitive impairment was analyzed by using the Chinese revised Wechsler Adult Intelligence scale and the Chinese revised Wechsler Adult memory scale. Results the younger the onset age, the longer the course, the higher the history of febrile convulsion, the lower the value of NAA / (Cho Cr) in hippocampus and the more serious the cognitive impairment in the patients with TLE with HS than those without HS (P0.05), the patients with TLE with HS had more cognitive impairment than those with TLE without HS, and the patients with GTCS had lower NAA / (Cho Cr) and more serious cognitive impairment (P0.05). The decrease of NAA / (Cho Cr) in hippocampus of HS patients was significantly correlated with the degree of cognitive impairment (P0.05). Conclusion the onset age, course of disease, history of febrile convulsion and GTCS attack are associated with cognitive impairment in TLE patients. 1H-MRS examination in hippocampus of TLE patients is helpful for early evaluation and detection of cognitive impairment, and it is helpful to select antiepileptic drugs for clinical use. To add drugs to improve cognitive impairment, improve the quality of life of patients with the basis.
【作者单位】：昆明医科大学附属延安医院神经内科;昆明医科大学附属延安医院影像科;
【分类号】：R742.1

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