CAJ | 학술논문

目的探讨伴有中央颞区棘波的儿童良件癫(癎)(BECT)患儿的智力水平及智力结构状况,研究各种因素对BECT患儿智力结构的影响.方法采用中国修订韦氏儿童智力量表(WISC-R)及多重评估法对47例BECT患儿进行韦氏智力测验,语音意识测验和语素意识测验,并与在性别、年龄、文化程度和家庭背景等方面与之相匹配的30名健康儿童作对照比较,同时分析起病年龄、病程、发作频率、发作类型、放电部位和棘慢波指数等临床因素对BECT患儿智力和智力结构的影响.结果 47例BECT患儿平均总智商为104.20±12.34,较对照组(109.45±15.01)略低,但差异无统计学意义,2组之间的操作智商差异亦无统计学意义,仅语言智商(90.67±18.40)与对照组(98.17±13.18)相比显著降低(t=3.431,P<0.05);在语言智商各子项分析中,2组受试者之间"词汇"和"类同"项目差异存在统计学意义(BECT组:5.97±2.95、4.85±3.02,健康对照组:8.51±3.67、6.95±3.07,t=2.365、2.096,均P<0.05);BECT患儿的语音意识得分为12.56±2.34,语素意识得分为22.35±3.25,健康儿童分别为16.78±3.72和24.15±5.28,差异均有统计学意义(t=2.478、2.770,P<0.05);语言智商、"类同"、"词汇"、语音意识及语素意识与非快动眼睡眠(NREM)期棘慢波指数呈负相关(r=-0.305～-0.838,P<0.05),与起病年龄、病程和发作频率无相关性.左侧、右侧和双侧病灶者患儿间智商差异无统计学意义.部分性发作及部分性发作继发全身性发作组之间智商差异亦无统计学意义.结论 BECT患儿有正常的智力,但其智力结构存在不平衡现象,语言功能滞后于健康儿童.棘波指数影响BECT患儿的语言功能,而起病年龄、发作类型和放电部位对语言功能影响不大.
목적 탐토반유중앙섭구극파적인동량건전(간)(BECT)환인적지력수평급지력결구상황,연구각충인소대BECT환인지력결구적영향.방법 채용중국수정위씨인동지역량표(WISC-R)급다중평고법대47례BECT환인진행위씨지력측험,어음의식측험화어소의식측험,병여재성별、년령、문화정도화가정배경등방면여지상필배적30명건강인동작대조비교,동시분석기병년령、병정、발작빈솔、발작류형、방전부위화극만파지수등림상인소대BECT환인지력화지력결구적영향.결과 47례BECT환인평균총지상위104.20±12.34,교대조조(109.45±15.01)략저,단차이무통계학의의,2조지간적조작지상차이역무통계학의의,부어언지상(90.67±18.40)여대조조(98.17±13.18)상비현저강저(t=3.431,P<0.05);재어언지상각자항분석중,2조수시자지간"사회"화"류동"항목차이존재통계학의의(BECT조:5.97±2.95、4.85±3.02,건강대조조:8.51±3.67、6.95±3.07,t=2.365、2.096,균P<0.05);BECT환인적어음의식득분위12.56±2.34,어소의식득분위22.35±3.25,건강인동분별위16.78±3.72화24.15±5.28,차이균유통계학의의(t=2.478、2.770,P<0.05);어언지상、"류동"、"사회"、어음의식급어소의식여비쾌동안수면(NREM)기극만파지수정부상관(r=-0.305～-0.838,P<0.05),여기병년령、병정화발작빈솔무상관성.좌측、우측화쌍측병조자환인간지상차이무통계학의의.부분성발작급부분성발작계발전신성발작조지간지상차이역무통계학의의.결론 BECT환인유정상적지력,단기지력결구존재불평형현상,어언공능체후우건강인동.극파지수영향BECT환인적어언공능,이기병년령、발작류형화방전부위대어언공능영향불대.
Objective To study the level and structure of intelligence in children with benign epilepsy of childhood with centrotemporal spikes(BECT)and investigate factors affecting their intelligence.Methods Congitive skills such as intelligence quotient(IQ),phonological test and morphological test,were evaluated in 47 children with BECT,and the results were compared to a control group of 30 children matched for gender,age,level of education and family background.The effects of age of onset,disease course,seizure frequency,seizure type,location of spike,and spike and wave index(SWI)on the level and structure of intelligence were also analyzed.Results The total IQ score was slightly lower in children with BECT(104.20±12.34)when compared to the control group of normal children(109.45±15.01),but the difference was not significant.There was no difference in performance IQ scores between BECT and normal children.BECT children had a lower verbal IQ score(90.67±18.40)when compared to the control group(98.17±13.18,t=3.431.P<0.05).Analyses of verbal subtests revealed significant differences between BECT and normal children in vocabulary and similarities(5.97±2.95 vs 8.51±3.67 and 4.85±3.02 vs 6.95±3.07,respectively,t value were 2.365 and 2.096,both P<0.05).The differences between BECT and normal children were also significant in phonological test and morphological test (12.56±2.3 vs 16.78±3.72 and 22.35±3.25 vs 24.15±5.28,respectively,t=2.478 and 2.770,both P<0.05).SWI was negatively correlated with verbal IQ,vocabulary,similarities,phonological test and morphological test(r=-0.305--0.838,P<0.05).Age of onset,disease course and seizure frequency were not correlated with verbal IQ,phonological test and morphological test.The level of intelligence was not different among children with left hemispheric foci,fight hemispheric foci or bilateral foci.The level of intelligence Was similar between children with partial seizures or secondarily generalized seizures.Conclusions Children with BECT have normal level of intelligence,but the structure of intelligence is abnormal with retardation of their language ability.SWI affects the language ability in children with BECT,but age of onset,seizure type and location of spike do not influence their language ability.