CAJ | 학술논문

目的：探讨阿尔茨海默病（AD ）伴发癫痫的发生率、机制、临床治疗及癫痫对AD病情的影响。方法回顾分析2000-2012年120例AD患者，分析癫痫发生率，将19例AD伴发癫痫病人设为观察组，101例AD不伴癫痫病人设为对照组，分析19例AD患者伴发癫痫的临床治疗、辅助检查结果及癫痫对 AD病情的影响。结果120例 AD 患者中19例（15.8％）伴癫痫发作，其中AD早期7例，中期3例，晚期9例；癫痫发作类型，全身性强直-阵挛发作8例，复杂部分性发作13例，单纯部分性发作2例，2例出现癫痫持续状态；AD伴癫痫组患者发病年龄明显小于AD不伴癫痫组（ P＜0.05），AD伴发癫痫组患者平均生存期明显短于AD不伴癫痫组（P＜0.05）；AD伴发癫痫组脑萎缩明显；AD病人出现癫痫，应用抗癫痫药物治疗效果欠佳，在AD症状加重时癫痫发作增多。结论 AD有15.8％伴癫痫发作，癫痫发作可在AD任何时期，AD伴发癫痫患者发病年龄小，癫痫加重AD病情发展，生存时间短。AD伴发癫痫相关的机制与神经元丧失、颞叶海马硬化有关，抗癫痫药物治疗效果欠佳。
목적：탐토아이자해묵병（AD ）반발전간적발생솔、궤제、림상치료급전간대AD병정적영향。방법회고분석2000-2012년120례AD환자，분석전간발생솔，장19례AD반발전간병인설위관찰조，101례AD불반전간병인설위대조조，분석19례AD환자반발전간적림상치료、보조검사결과급전간대 AD병정적영향。결과120례 AD 환자중19례（15.8％）반전간발작，기중AD조기7례，중기3례，만기9례；전간발작류형，전신성강직-진련발작8례，복잡부분성발작13례，단순부분성발작2례，2례출현전간지속상태；AD반전간조환자발병년령명현소우AD불반전간조（ P＜0.05），AD반발전간조환자평균생존기명현단우AD불반전간조（P＜0.05）；AD반발전간조뇌위축명현；AD병인출현전간，응용항전간약물치료효과흠가，재AD증상가중시전간발작증다。결론 AD유15.8％반전간발작，전간발작가재AD임하시기，AD반발전간환자발병년령소，전간가중AD병정발전，생존시간단。AD반발전간상관적궤제여신경원상실、섭협해마경화유관，항전간약물치료효과흠가。
Objective To explore the incidence rate of epilepsy secondary to Alzheimer ,s disease (AD)、its pathogenesis、clinical treatment and its effect on AD. Methods the data of 120 patients with AD from 2000-2012 were retrospectively ana-lyzed ,the incidence rate of Epilepsy secondary to AD was analyzed. 19 AD patients complicated with Epilepsy were classified to the observation group ,101 AD patients without Epilepsy to the control group. And then the clinical treatment and accessory examinations of 19 AD patients complicated with Epilepsy and the effect of Epilepsy on AD were analyzed. Results Among the 120 AD patients ,19 cases were complicated with Epilepsy (15.8% ) ,Among which ,7 cases occurred in early stage ,3 cases in middle ,9 cases in late ;according to the seizure types of Epilepsy ,they included :8 cases of generalized tonic-clonic seizure ,13 cases of complex partial seizures ,2 cases of simple partial seizure. 2 cases of the 19 patients had status epilepticus ;Mean age of AD patients with Epilepsy was less than that of AD without Epilepsy (P<0.05) ,mean survival time of AD patients with Epi-lepsy was shorter than that of those without Epilepsy (P<0.05) ;Brain atrophy was significantly obvious in AD with Epilepsy group ;The antiepileptic drug was not very effective in controlling the Epileptic seizure in patients with AD ,The frequency of Epileptic seizures increased as the symptoms of AD exacerbated. Conclusion The incidence rate of Epilepsy in AD is 15.8%.Epilepsy may occur at any time in AD ,mean age of onset of Epilepsy in AD is small ,mean survival time is short. Epilepsy can worsen AD symptoms and shorten the survival time of AD. The pathogenesis of Epilepsy in AD is associated with loss of neu-rons ,temporal lobe and hippocampal sclerosis. The antiepileptic drug is not very effective in controlling the Epileptic seizure in patients w ith AD.