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脑梗死后癫痫发作相关因素分析
引用本文:卢颖瑜,王鹏,巫碧佳. 脑梗死后癫痫发作相关因素分析[J]. 中国医学创新, 2013, 0(17): 144-146
作者姓名:卢颖瑜  王鹏  巫碧佳
作者单位:卢颖瑜 (广东省佛山市第二人民医院 广东 佛山 528000); 王鹏 (广东省佛山市第二人民医院 广东 佛山 528000); 巫碧佳 (广东省佛山市第二人民医院 广东 佛山 528000);
摘    要:目的:对影响脑梗死后癫痫(PIE)发作及难治性脑梗死后癫痫的相关因素进行回顾性分析。方法:对1993年1月-2011年12月在本院住院诊断的脑梗死患者进行回顾性研究。以脑梗死后癫痫及难治性癫痫为评价指标。分析因素包括:年龄、性别、癫痫发作类型、首次发作出现的时间、间隙期脑电图、神经影像学资料、早期溶栓治疗等。结果:628例患者纳入本研究,年龄36~89岁,平均63.2岁,其中59例出现脑梗死后癫痫(9.39%),其中18例为部分性发作。难治性癫痫出现的相关危险因素:年龄(OR=3.73,95%CI2.65~5.30,P=0.021),意识障碍(OR=5.61,95%CI2.42~10.36,P=0.013),颞叶受损(OR=8.25,95%CI5.80~26.53,P=0.000),间隙期脑电图癫痫样放电(OR=11.70,95%CI8.52~35.03,P=0.000)等。难治性癫痫16例,发生的相关因素:部分性发作(OR=3.09,95%CI2.24~10.91,P=0.032),早期癫痫持续状态(OR=4.78,95%CI1.68~9.32,P=0.011),问隙期脑电图多灶性棘慢波(OR=6.65,95%CI8.02~16.19,P=0.036),颞叶受损(OR=2.33,95%CI1.75~8.27,P=0.001)和急性期难以控制的发作(OR=6.13,95%CI4.55~13.35,P=0.001)。早期溶栓治疗(OR=2.39,95%CI1.15~5.87,P=0.029)和首次发作延迟(OR=4.74,95%CI3.15~10.32,P=0.015)可以减少难治性癫痫的出现风险。结论:脑梗死后癫痫是脑梗死后患者常见的并发症,特别是难治性癫痫较为多见,有多种因素与其有相关性。

关 键 词:脑梗死  癫痫  相关因素  回顾性研究

Study on the Related Factors of Post-cerebral Infraction Epilepsy
LU Ying-yu,WANG Peng,WU Bi-Jia. Study on the Related Factors of Post-cerebral Infraction Epilepsy[J]. Medical Innovation of China, 2013, 0(17): 144-146
Authors:LU Ying-yu  WANG Peng  WU Bi-Jia
Affiliation:( The Second People's Hospital of Foshan, Foshan 528000, China)
Abstract:Objective: To analyze retrospectively the risk factors and predictors of post-cerebral infraction epilepsy ( PIE ) and refractory epilepsy in patients with cerebral infraction. Method: In a hospital based study, the patients with cerebral infraction were reviewed retrospectively between the January of 1993 and December of 2011. Related factors were evaluated including age, sex, seizure types, neuroimaging, electroencephalogram ( EEG ) in intermittent period, clinical symptoms, etc. Result: 628 patients with cerebral infraction were enrolled, whose median age was 63.2 ( range 36-89 )years old. PIE occurred in 59 ( 9.39% ) patients; and 18 of whom had partial seizure. Significant risk factors for PIE included age ( OR=3.73, 95%CI 2.65-5.30, P=0.021 ), disturbance of consciousness level ( OR=5.61, 95%CI 2.42-10.36, P=0.013 ), Damaged of temporal lobe ( OR=8.25, 95%CI 5.80-26.53, P=0.000 ), spike discharge in EEG ( OR=11.70, 95%CI 8.52-35.03, P=0.000 ) . The refractory epilepsy occurred in 16 patients. The significant risk factors of refractory PIE, included focal seizures ( OR=3.09, 95%CI 2.24-10.91 P=0.032 ), status epilepticus ( 0R=4.78, 95%CI 1.68-9.32, P=0.011 ) and poor controlled seizure ( OR=6.13, 95%CI 4.55-13.35, P=0.001 ) during acute phase, multifocal spikes discharge in EEG ( OR=6.65, 95%CI 8.02- 16.19, P=0.036 ), Damaged of temporal lobe ( OR=2.33, 95%CI 1.75-8,27, P=0.001 ), however, early thrombolysis therapy ( OR=2.39, 95%CI 1.15- 5.87, P=0.029 ) and longer time to initial seizure ( OR=4.74, 95%CI 3.15-10.32, P=0.015 ) could significantly reduce the incidence of refractory epilepsy in PIE patients. Conclusion: PIE is a common complication, especially refractory epilepsy. It is related with many factors.
Keywords:Cerebral infraction  Epilepsy  Related factors  Retrospective studies
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