Seizure reduction and quality of life improvements in people with epilepsy
Seizure reduction and quality of life improvements in people with epilepsy
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DOI：
10.1046/j.1528-1157.2002.32201.x
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发表时间：
2002-05-01
期刊：
影响因子：
5.6
通讯作者：
Vickrey, BG
中科院分区：
文献类型：
--
作者：
Birbeck, GL;Hays, RD;Vickrey, BG
目的：先前的研究表明癫痫手术患者的癫痫发作自由可能是改善健康相关生活质量(HRQOL)所必需的，但关于减少癫痫发作频率以改善接受内科治疗的个体的HRQOL知之甚少。方法：通过134例参加随机对照抗癫痫药物(AED)试验的成人难治性复杂部分性癫痫患者的数据，我们比较了癫痫发作频率变化程度不同的组之间的HRQOL变化：100%、75%-99%、50%-74%和0-50%增加或减少。还评估了每个癫痫减少组内随时间的变化。采用QOLIE-31、QOLIE-89和SF-36量表对患者的生活质量进行测评。结果：在QOLIE-31和QOLIE-89总分、QOLIE-89精神健康、躯体健康和癫痫目标综合评分以及SF-36精神健康总分上，QOLIE-31、QOLIE-89总分和SF-36精神健康总分的积极变化显著高于无癫痫发作的患者。随着时间的推移，总体QOLIE-31和QOLIE-89得分的变化对于获得癫痫自由(即癫痫发作频率减少100%)的受试者比那些没有获得癫痫自由的受试者显著更积极。未达到惊厥完全解脱者的QOLIE-31和QOLIE-89总分没有显著变化。结论：在本研究中，HRQOL的改善主要发生在达到完全惊厥解脱者。许多AED试验使用50%的癫痫发作频率减少标准作为试验终点，但在本样本中，没有观察到这种程度的癫痫发作频率减少对HRQOL的可测量影响。这些结果进一步支持将争取癫痫发作自由作为癫痫治疗的目标。
Purpose: Previous research suggests that seizure freedom may be necessary to improve health-related quality of life (HRQOL) for epilepsy surgery patients, but little is known regarding the seizure-frequency reduction needed to improve HRQOL among medically treated individuals.Methods: With data from 134 adults with refractory complex partial seizures participating in a randomized controlled anti-epileptic drug (AED) trial, we compared the change in HRQOL across groups having different levels of change in seizure frequency: 100%, 75-99%, 50-74% reduction, and 0-50% increase or decrease. Changes over time within each seizure-reduction group also were assessed. HRQOL was measured by the QOLIE-31, QOLIE-89, and SF-36.Results: Subjects who became seizure free reported significantly more positive change than those who did not on the QOLIE-31 and QOLIE-89 overall scores, the QOLIE-89 mental health, physical health, and epilepsy-targeted composites, as well as the SF-36 mental health summary score. Changes over time in overall QOLIE-31 and QOLIE-89 scores were significantly more positive for subjects who achieved seizure freedom (i.e., 100% reduction in seizure frequency) than for those who did not. No significant change in QOLIE-31 and QOLIE-89 overall scores was observed for subjects who did not achieve seizure freedom.Conclusions: In this study, HRQOL improvement occurred primarily among patients who achieved complete seizure freedom. Many AED trials use a 50% seizure-frequency reduction criterion as a trial end point, but measurable impacts of this degree of reduction in seizure frequency on HRQOL in this sample were not observed. These results further support striving for seizure freedom as an epilepsy care goal.