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目的分析家族性全面性强直-阵挛性发作(GTCS)患儿和他们同胞的智商(IQ),探讨影响癫患儿IQ的相关因素。方法选择皖南山区20个癫家系中的9～16岁的GTCS患儿28例作为试验组,随机抽选28例与患儿年龄差距最小同胞儿童为对照1组,30例同村的年龄、性别匹配相近的健康儿童为对照2组,比较3组儿童的IQ水平;并记录癫发病的相关资料和影响儿童IQ的因素。结果1.试验组32%儿童IQ在平均水平,21%高于平均水平;与对照1组及对照2组比较均有显著差异(Pa<0.01);2.试验组儿童的总智商较对照1组、对照2组均显著降低(Pa<0.001),除了填图与图片排列外,试验组所有其他分测验得分和2个对照组之间均有显著性差异;3.2个对照组之间的IQ水平及各分测验得分无显著性差异;4.癫患儿IQ与父亲受教育程度、癫发病年龄、癫发作病程、癫发作频率、癫持续状态显著相关(r=0.453,0.506,-0.533,-0.708,-0.732Pa<0.05);5.多元线性逐步回归分析,父亲受教育程度与癫发作病程是影响癫患儿IQ的主要因素。结论家族性GTCS患儿的IQ及各分测验得分明显低于健康儿童;其同胞的IQ水平与健康儿童无统计学差异;癫发作病程、父亲受教育程度是影响患儿IQ最重要的癫因素,其他依次为:癫持续状态、起病年龄、癫发作次数、癫发作频率。
Objective To analyze the IQ of children with familial comprehensive tonic-clonic seizures (GTCS) and their siblings and to explore the related factors that influence the IQ of children with epilepsy. Methods Twenty-eight children with GTCS aged 9-16 years from 20 epileptic pedigrees in mountain area of Southern Anhui Province were selected as the experimental group. 28 children with the same age difference as the control group 1, 30 age-gender Matched healthy children as control group 2, compared the IQ of three groups of children; and recorded information on the incidence of epilepsy and factors that affect IQ in children. Results 1. IQ of 32% children in the experimental group was higher than the average level (21%), compared with the control group 1 and the control group 2 (P0.01); 2. The total IQ of the children in the experimental group was significantly higher than that of the control 1 (P <0.001). In addition to the mapping and image arrangement, all the other sub-test scores in the experimental group and the two control groups were significantly different; IQ between the two control groups (P <0.05) .4 There was a significant correlation between IQ and the level of education, the age of onset of epilepsy, the course of epileptic seizures, the frequency of epileptic seizures and the status of epileptic seizures in children with epilepsy (r = 0.453, 0.506, -0.533, -0.708, -0.732Pa <0.05) .5. Multivariate linear stepwise regression analysis, father’s education and the course of epileptic seizures were the main factors affecting the IQ of children with epilepsy. Conclusion The scores of IQ and each sub-test in familial GTCS children were significantly lower than those of healthy children. The IQ of their siblings was not statistically different from that of healthy children. The course of epileptic seizures and father’s education were the most important epilepsy factors, followed by the other: status of epilepsy, age of onset, number of epileptic seizures, epileptic seizure frequency.