缺血性卒中后癫痫发作复发和耐药的预测因素

目的：探讨缺血性卒中后癫痫发作复发和耐药性的预测因素。方法回顾性纳入连续的缺血性卒中后首次癫痫发作患者的临床资料，计算癫痫发作复发率及耐药发生率，应用生存分析及 Cox 比例风险模型分析癫痫发作复发和耐药的预测因素。结果共纳入74例连续的缺血性卒中后首次癫痫发作患者，男性45例，女性29例，年龄（66.64±11.50）岁；早发性癫痫发作患者26例，迟发性癫痫发作患者48例。迟发性癫痫发作优势比（odds ratio, OR）2.56，95％可信区间（confidence interval, CI）1.11~5.88；P =0.027]和部分性发作（OR 3.68，95％ CI 1.29~10.48；P =0.015）是缺血性卒中后癫痫发作复发的预测因素；早发性癫痫发作是耐药性的独立预测因素（OR 6.20，95％ CI 2.04~18.84；P =0.001）。结论迟发性癫痫发作和部分性发作患者易复发，早发性癫痫发作患者易产生耐药性。

Predictors of recurrence and drug resistance of seizures after ischemic stroke

Objective To investigate the predictors of recurrence and drug resistance of seizures after ischemic stroke. Methods The clinical data of the consecutive patients w ith the first seizures after ischemic stroke w ere enroled retrospectively. The rates of recurrence and drug resistance of seizures w ere calculated. The survival analysis and Cox proportional hazard model w ere used to analyze the predictors of recurrence and drug resistance of seizures. Results A total of 74 consecutive patients w ith first seizures after ischemic stroke w ere enroled, including 29 w omen and 45 men (aged 66.64 ±11.50 years). There w ere 26 patients w ith early seizures and 48 patients w ith delayed seizures. Delayed seizures (odds ratio OR] 2.556; 95%confidence interval CI] 1.11-5.88; P = 0.027) and partial seizures ( OR 3.68, 95% CI 1.29-10.48; P =0.015) w ere the predictors of seizures recurrence after ischemic stroke. Early seizures w as an independent predictor for drug-resistance (OR 6.20, 95% CI 2.04-18.84; P = 0.001). Conclusions The patients w ith delayed seizures and partial seizures are prone to recurrence. The patients w ith early seizures are easy to develop drug-resistance.