【摘要】 目的研究癫痫患者合并抑郁及认知功能减退的情况,通过改善抑郁观察认知功能的改变情况,明确癫痫后抑郁是否为认知功能减退的原因。方法选择癫痫患者共288例(分为轻、重度),根据汉密尔顿抑郁量表(HAWD-17)和认知功能神经心理量表(MMSE)评分,明确不同程度癫痫患者合并抑郁及认知障碍的比例;对有明确抑郁的患者予以积极干预,定期随访,横向比较癫痫程度不同对抑郁和认知功能的影响,纵向比较干预抑郁后对认知功能的影响。结果 (1)癫痫患者合并抑郁及认知障碍的比例高于一般人群,差异有统计学意义(P<0.05);(2)癫痫程度越重,合并抑郁及认知障碍的比例越高,差异有统计学意义;(3)对抑郁进行干预后患者认知功能也有改善,但改善程度不如抑郁的改善明显。结论癫痫后抑郁可影响患者的认知功能,但癫痫患者认知功能减退的程度与抑郁不成正比,考虑认知功能减退还有别的因素参与。更多还原

【Abstract】 Objective To investigate cognitive decline in patients with epilepsy and depression, to determine the changes of cognitive function by improving depression, and to identify whether post-epileptic depression is the cause of cognitive decline. Methods A total of 288 patients with epilepsy(mild and severe) were included in the study. According to the scores of Hamilton Depression Scale(HAMD) and Mini-Mental State Examination(MMSE),the proportion of patients with different levels of epilepsy, depression and cognitive impairment was determined. The patients diagnosed with depression received active intervention and regular follow-up. The effect of different levels of epilepsy on depression and cognitive function was compared horizontally. The effect of intervention on cognitive function after depression was compared longitudinally. Results(1) The proportion of patients with epilepsy,depression and cognitive impairment was higher than that in the general population, with statistically significant difference(P<0.05).(2)The more severe the epilepsy, the higher the proportion of combined depression and cognitive impairment, with statistically significant difference.(3) The cognitive function of the patients was improved after intervention of depression, but the improvement was not as good as that of depression. Conclusion Post-epileptic depression may affect the cognitive function of patients, whereas the level of cognitive decline in patients with epilepsy is not proportional to depression, suggesting other factors may be involved in cognitive decline.更多还原