首次自发性痫性发作后复发危险性分析探讨

目的 探讨首次自发性痫性发作后复发的危险性及潜在危险因素.方法 选择1998-10～2007-06间于神经内科和小儿科首诊就诊的首次痫性发作病人66例,随访2年,记录有无再次复发,应用Kaplan-Meier乘积限法估算复发率,针对66例首次痫性发作患者,应用Cox比例风险模型的单因素和多因素分析来探讨分析影响首次痫性发作后复发的潜在危险因素.结果 66例首次痫性发作患者2年中复发36例,累积复发率为54.55%.Cox单因素和多因素分析表明,首次痫性发作后,症状性发作复发的危险性较大;另外EEG异常、首次发作出现在睡眠状态中、首次发作持续时间较长等亦是复发的危险因素,而3～12岁间出现的首次痫性发作复发率较低.结论 首次痫性发作的某些临床特点可以帮助判断其复发危险性.

A analytic study of the risk of recurrence after a first unprovoked seizure

Objective To study the risk of recurrence after a first unprovoked seizure and analyze the potential predictors of recurrence. Methods Sixty-six patients having a first unprovoked seizure who attended our hospital from October 1998 to June 2007, were followed up for 2 years. Recurrence rate was estimated by Kaplan-Meier curves. Univariate and multivariate analyses of the potential predictors of recurrence were performed for the first unprovoked seizure patients using the Cox proportional hazards model. Results Sixty-six first unprovoked seizure patients had 36 relapses in two years, with the recurrence rate 54. 55%. Cox Univariate and multivariate analyses showed that symptomatic etiology increased the risk of recurrence, and other predictors of recurrence included abnormal electroencephalogram,the occurrence of seizures during sleep and first seizure lasting longer than 10 minutes, whereas an age of 3 to 12 years decreased this risk. Conclusion The recurrence risk after the first unprovoked seizure is lower than those who have two or more recent seizures. Several factors enable us to predict the recurrence risk after a first unprovoked seizure.