血药浓度监测对成人癫痫患者认知功能的影响

目的 观察血药浓度监测对成人癫痫患者认知功能的影响。方法 对服用抗癫痫药治疗成人癫痫患者进行了血药浓度和认知功能的评定,观察其药物影响的特点。结果 (1)患者组在有效治疗浓度范围内认知功能提高,和调整用药前比较差别有显著性意义(P<0.05);(2)血药浓度与认知功能呈显著正相关(r=0.638,P<0.05)。结论 成人癫痫患者存在认知功能下降,血药浓度监测可指导合理用药,提高患者认知功能。     

成人癫痫患者生活质量评定研究进展

癫痫（EP）是一种常见的慢性神经系统疾病,EP的反复发作、长期服用抗癫痫药物（AEDs）、社会歧视等使患者的生活质量显著下降,成人EP患者生活质量受躯体、社会、心理等多方面因素的影响。有效控制患者的EP发作,尽量采用单药治疗、个体化用药及应用新型AEDs等,并提高EP患者的社会支持,从而提高EP患者的生活质量。     

拉莫三嗪对新诊断成人原发性癫痫患者生活质量的影响

目的探讨拉莫三嗪(LTG)治疗新诊断成人原发性癫痫的临床疗效。方法选择符合标准的癫痫患者40例,采用LTG单药治疗,观察记录治疗前后癫痫发作次数及成人癫痫患者生活质量量表-31(QOLIE-31)评分。结果控制16例(40.0%),显效14例(35.00%),有效8例(20.00%),无效2例(5.00%)。治疗后患者QOLIE-31各维度评分较治疗前均提高,差异有统计学意义(P0.05)。癫痫发作频率减少百分率与QOLIE-31总评分呈显著正相关关系(r=0.350,P0.05)。结论 LTG治疗新诊断成人原发性癫痫具有较高的癫痫发作控制率,临床疗效显著,可以明显改善患者的生存状态和生活质量。     

癫痫患者生活质量影响因素分析

目的 调查和分析影响癫痫患者生活质量的相关因素,为采取相应措施提高癫痫患者的生活质量提供理论依据.方法 选择自2007年7月至2008年12月在广州医学院第二附属医院癫痫中心就诊的门诊及住院癫痫患者65例,采用癫痫患者生活质量表-31(中文版)对患者进行问卷调查,以患者的年龄、性别、文化程度、发作类型、病程、认知功能、用药依从性、发作担忧作为自变量,以生活质量表-31(中文版)中相关评分作为应变量,多元线性回归分析应变量和自变量之间的线性关系.结果 文化程度、病程可以影响癫痫患者的记忆力(标准化回归系数分别为0.380、0.264);年龄可以影响患者的社会活动(标准化回归系数为-0.303);性别影响患者的发作(标准化回归系数为0.332).结论 影响癫痫患者生活质量的因素是年龄、性别、病程、文化程度等,且病程与文化程度影响最大.     

癫痫患者的生活质量及其影响因素的研究进展

癫痫使患者的生活质量显著下降。癫痫患者的抑郁、焦虑及其他心理精神方面的异常远高于社会一般人群;认知功能有明显下降;躯体健康及婚姻、就业等社会功能亦受影响。影响癫痫患者生活质量的因素包括:癫痫患者自身的认知、痫性发作本身的特点(发作频率、发作类型及严重程度、起病年龄和病程等)、药物不良反应、多药治疗及手术等。提高癫痫患者的生活质量,最根本的是控制癫痫发作,同时进行心理干预和认知-行为治疗等。     

成年癫痫患者生活质量的有关问题

癫痫是神经科常见的慢性疾病。如果坚持正规治疗 ,80 %的患者可以完全控制发作[1] ,但仍有 2 0 %患者发作难以控制。反复的癫痫发作不仅对患者的身心健康造成损害 ,长期服药、社会歧视等因素也同样给患者及其家属乃至社会带来了巨大的心理压力和沉重的经济负担。随着医学模式从单纯的生物医学模式转变为生物、心理及社会医学模式 ,以往沿用的反映健康的指标如死亡率、患病率等已不适用 ,而生活质量 (ｑｕａｌｉｔｙｏｆｌｉｆｅ ,ＱＯＬ)这一反映健康的新指标日益受到重视。一、生活质量的定义生活质量 ,又称生命质量或生存质量 ,在医学研究…     

成年癫痫病人的生活质量及其影响因素

目的　研究癫痫病人的生活质量及其影响因素 ,为进一步治疗提供线索 ,以提高病人生活质量。方法　用癫痫病人生活质量量表 30 (QOLIE 30 )对 10 6例临床确诊的成人癫痫病人和 6 4名对照进行评定。结果　癫痫组较对照组生活质量明显降低 [QOL得分分别为 5 4± 16和 77± 15 ],表现在惧怕发作 ,对日常生活不满意 ,情绪差 ,精力不足 ,认知功能下降 ,对长期服用抗癫痫药物的顾虑较多 ,社交、工作受限等。不同性别、不同病程、不同用药数量、不同发作频率病人的生活质量比较 ,用药和发作频率对生活质量影响较大 ,QOL与用药数量呈负相关 ,与发作频率负相关。结论　癫痫病人生活质量明显降低 ,用药和发作频率对生活质量影响较大 ,合适的药物控制癫痫发作是提高癫痫病人生活质量的关键。     

成年癫痫患者生活质量的研究

目的　评价成年癫痫患者的生活质量。方法　对符合入选标准的 33例成年癫痫患者和正常对照者 17名 ,进行癫痫患者生活质量量表 31(QOLIE 31)、Zung氏抑郁自评表 (SDS)的评估。结果　SDS评分水平与QOL的多个方面呈独立负相关 ,病程是总体健康水平、药物影响的独立危险因素。全身强直 阵挛发作 (GTC ,17例 )、复杂部分性发作 (CPS ,16例 )两组患者在药物影响 (分别为 6 1 0± 2 3 8和 5 6 6± 19 4,对照组为 10 0± 0 0 )、对发作的担忧两方面均与对照组有显著性差异 (P <0 .0 0 1)。GTC组从事脑力劳动的人数大大低于学历背景相似的对照组 (P =0 0 1) ,而CPS组从事脑力劳动的人数与对照组相比差异无显著性意义 (P =0 .479) ,GTC组与CPS组相比未见显著性差异 (P =0 .0 97)。男性癫痫患者在婚育方面受到的影响有大于女性患者的趋势。结论　成年癫痫患者生活质量低于健康对照组。     

卡马西平治疗癫痫血药浓度监测

目的指导临床合理应用卡马西平。方法按起始剂量5mg／kg单药服用卡马西平54名患者,1周及2周后荧光偏振免疫法进行血药浓度测定。结果1周后大多数患者血药浓度在正常范围内（90％）,2周后多数低于正常范围（89％）,副作用很少发生。结论卡马西平按起始剂量5mg／kg,1周后逐渐加量,能达到治疗效果且减少副作用。     

拉莫三嗪对癫痫患者生活质量影响的研究

目的：评价拉莫三嗪对癫痫患者生活质量的影响。方法：采用多中心、前瞻性的研究方法,对新诊断癫痫患者应用拉莫三嗪治疗,并在基线期及用药6个月后,采用QOLIE-31、MOSSF-36量表、数字符号转换测验、HAMD抑郁量表和女性专用调查问卷对患者进行生活质量评价。结果：共纳入新诊断癫痂患者282例。MOSSF-36量表的8个项目得分在用药后均有显著提高（P〈0．01）;QOLIE-31问卷中“对癫痫的担心”、“情绪”、“活力”、“认知”、“药物不良反应”、“社会功能”及“总体自身健康评价”项目得分在用药后均有显著提高（P〈0．01）。用药后,患者Hamilton抑郁量表平均3．65分,显著低于基线期6．42分（P〈0．01）;数字符号转换测验得分在用药后与基线期比较有显著提高（P〈0．01）。结论：拉莫三嗪初始单药治疗能在一定程度上改善新诊断癫痫患者的生活质量。     

Quality of Life in Adult Patients with Epilepsy

Summary: Quality of life (QOL) must be determined from the patients' subjective viewpoint. To determine QOL in epilepsy, it is necessary to use disease-specific scales. We introduced the Side Effects and Life Satisfaction (SEALS) scale to Japan and performed a comparative study on adult patients with epilepsy and normal subjects. The results for patients with epilepsy were determined by the number of prescribed antiepileptic drugs (AEDs), the total dosage, and the type of epilepsy. Problems in patients with epilepsy were expressed by vertically crossing lines. A horizontal line expressed the severity of disease, and a vertical line expressed the psychosocial functioning. Therefore we cannot separate the severity and QOL when considering the influence of epilepsy disorders on individual patients. These two components compose the biphasic dimensions of QOL and thus are analyzed coincidentally. The concepts of QOL and comprehensive management in epilepsy are closely related, but the fundamental viewpoints are located at opposite positions. The former is based on the physicians' viewpoints and the latter on the patients' viewpoints. Although ideally these two concepts should be in harmony, they are in reality frequently dissociated. In comprehensive management, the treating physician must vigorously consider the influence of therapy on the patients' QOL.     

癫痫患者的生活质量及其评定工具

生活质量应能反映多维的健康状况,至少包括由疾病或治疗引起的生理、心理和社会效应。相关的生活质量评定工具通常分为一般(不针对特定的年龄、疾病或治疗组)和特异(针对特定的症状、疾病或与治疗相关的患者的情况)两种。理想的生活质量评定工具应满足正确性、使用的广泛性和量表内容的特异性。同时满足这3个要求的有WPSI,ESI-55,QOLIE,LiverpoolBatteries等,研究癫患者生活质量时可作为首选。另外SF-36,改良SEALS等满足其中两个要求,可根据需要选用,因为可与对照组比较,预计将来会得到更广泛的应用。其他的生活质量评定工具,都推荐作为次选。我们也建议同时使用一般和癫特异生活质量量表。     

左乙拉西坦添加治疗对难治性部分性癫(癎)患者生活质量影响的研究

目的:评价新型抗癫药物左乙拉西坦(Lev)作为添加治疗对难治性部分性癫患者生活质量的影响。方法:43例确诊有癫部分性发作的成年患者随机分为两组:Lev治疗组与安慰剂组,Lev治疗16周后比较两组的有效率和不良反应,并用QOLIE-31量表对两组癫患者进行生活质量评定,所有患者在转入Lev开放性治疗6个月后再次进行QOLIE评估。结果:16周治疗期末Lev组癫部分性发作的治疗有效率明显高于安慰剂组,两组不良反应的发生率相当;Lev组生活质量明显高于安慰剂组,两组患者转入开放性治疗6个月后,生活质量均显著改善。结论:Lev作为添加用药治疗成人难治性部分性癫发作,显著减少发作频率、安全耐受性较好,能够提高癫患者的生活质量。     

Mediating Effect of Depressive Symptoms on the Relationship between Adult Attention Deficit Hyperactivity Disorder and Quality of Life

Objective

The aim of this study was to investigate whether depressive symptoms affect the relationship between adult attention deficit hyperactivity disorder (ADHD) and the quality of life (QOL) in Korean soldiers.

Methods

We evaluated past and present symptoms of adult ADHD (the Korean Adult Attention-Deficit/Hyperactivity Disorder Scale and the Wender Utah Rating Scale), depression (the Center for Epidemiological Studies Depression Scale) and QOL (the Korean version of the SmithKline Beecham ''Quality of Life'' scale) in 131 soldiers during mental health screenings performed by a local mental health center. A structured equation model using AMOS 19.0 was used to evaluate the mediating effect of depression.

Results

In our first model (without depressive symptoms), adult ADHD significantly affected QOL (standardized regression weight=-0.51, p<0.01). After depressive symptoms were added to this model, the direct effect of adult ADHD on QOL was not significant (standardized regression weight=0.10, p=0.43). Regarding the indirect effect, adult ADHD significantly affected depression (standardized regression weight=0.78, p<0.01), and depression also affected QOL (standardized regression weight=-0.79, p<0.01).

Conclusion

Through structural equation modeling, the complete mediation model for the influence of depressive symptoms on ADHD and QOL was confirmed. These findings indicated that it might be important to consider comorbidities, such as depression, when adult ADHD is being evaluated.     

育龄期女性癫痫患者社会心理及生活质量的研究

目的：研究女性癫痫患者社会心理及生活质量损害的特点及其影响因素。方法：对161例18-50岁女性（女性癫痫患者81例及健康女性80例）进行一般生活情况,疾病史及妇产科病史的调查。应用抗癫痫药物的不良反应量表,癫痫患者的生活质量-31项量表,焦虑自评量表,汉密尔顿抑郁量表,亚利桑那州女性性体验量表,进行社会心理和生活质量评定,比较其在癫痫患者与正常女性之间的差异并探索相关的影响因素。结果：女性癫痫患者存在广泛的社会心理及生活质量损害。女性患者在抑郁发生和性功能障碍与健康女性有明显差异。抑郁、性功能障碍、癫痫发作频率、抗癫痫药物的不良反应、个人收入、用药依从性是影响女性癫痂患者生活质量的重要因素。结论：育龄期女性癫痫患者需要更多的治疗和心理方面的关心指导,以利于提高其生活质量。     

Adolescent and Maternal Perspectives of Quality of Life and Neuropsychological Status Following Epilepsy Surgery

A convenience sample of 13 adolescents who had undergone epilepsy surgery and their mothers reported their perceptions of change in areas affecting quality of life (physical, affect/behavior, social, cognition/academics, and family). A mixed method approach was used, with self-report and maternal-report narratives (qualitative measures), as well as neuropsychological profiles (quantitative measures). The results demonstrate that change after epilepsy surgery is multifaceted, and that adolescent and maternal perceptions are notably different. Whereas most adolescents experienced positive changes, mothers simultaneously reported many more negative changes along with positive changes. Furthermore, mothers frequently described aspects of their adolescent's life that continued to be of concern, whereas adolescents did not. The findings strongly suggest that the processes involved in postsurgical adjustment are complex. The development of a theoretical model is essential to help build an understanding of factors that contribute to positive and negative outcomes.     

Effect of Long-Term Treatment with Vagus Nerve Stimulation on Mood and Quality of Life in Korean Patients with Drug-Resistant Epilepsy

Background and PurposeThis study aimed to determine the long-term effects of vagus nerve stimulation (VNS) treatment on suicidality, mood-related symptoms, and quality of life (QOL) in patients with drug-resistant epilepsy (DRE). We also investigated the relationships among these main effects, clinical characteristics, and VNS parameters.MethodsAmong 35 epilepsy patients who underwent VNS implantation consecutively in our epilepsy center, 25 patients were recruited to this study for assessing the effects of VNS on suicidality, mood-related symptoms, and QOL. The differences in these variables between before and after VNS treatment were analyzed statistically using paired t-tests. Multiple linear regression analyses were also performed to determine how the patients'' demographic and clinical characteristics influenced the variables that showed statistically significant changes after long-term VNS treatment.ResultsAfter VNS, our patients showed significant improvements not only in the mean seizure frequency but also in suicidality, depression, and QOL. The reduction in depression was associated with the improvement in QOL and more-severe depression at baseline. The reduction in suicidality was associated with higher suicidality at baseline, smaller changes in depression, and less-severe depression at baseline. Improved QOL was associated with lower suicidality at baseline.ConclusionsThis study found that VNS decreased the mean seizure frequency in patients with DRE, and also improved their depression, suicidality, and QOL. These results provide further evidence for therapeutic effect of VNS on psychological comorbidities of patients with DRE.