【摘要】 认知损害是癫■患者的常见并发症，老年期新发癫■或老年慢性癫■患者均可出现认知损害，可能与癫■发作、抗癫■发作药物(ASMs)的使用、血管性危险因素、炎症等与痴呆共同的危险因素有关。使用酶诱导性ASMs可诱导血脂异常。胆固醇增加可通过加重动脉粥样硬化及影响β淀粉样蛋白合成和清除而加重认知损害；高密度脂蛋白水平下降时神经保护作用减弱，亦可导致认知损害。临床研究表明老年癫■、认知损害、血脂异常三者间具有一定相关性，但其因果联系及具体机制仍需通过进一步的纵向研究和基础研究加以明确。更多还原

【Abstract】 Cognitive impairment is a common comorbidity of epilepsy. Elderly patients with newonset epilepsy or chronic epilepsy can experience cognitive decline, which may be related to seizures,antiseizure medications(ASMs), or common risk factors for dementia such as vascular risk factors,inflammation, and so on. Enzyme-induced ASMs can induce dyslipidemia. Increased cholesterol may worsen cognitive decline by aggravating atherosclerosis and affecting β-amyloid protein(Aβ) synthesis and clearance. When the level of high-density lipoprotein(HDL) decreases, its neuroprotective effects are weakened, which may be related to cognitive impairment. Clinical studies have shown a certain association among epilepsy, cognitive impairment and dyslipidemia in older adults, but the causal link and specific mechanism still need to be clarified through further longitudinal and basic research.更多还原