脑出血后癫痫发作患者临床特点分析

目的 分析脑出血急性期伴癫痫发作患者的临床特征。方法 本研究为回顾性研究,纳入2009-2018年住院的既往无癫痫病史的自发脑出血（发病14 d内）患者。根据脑出血急性期是否伴癫痫发作分为脑出血后癫痫发作组和脑出血后无癫痫发作组。比较两组的一般资料及合并高血压、糖尿病、高脂血症、肺部感染、认知功能障碍等疾病的特点,同时分析脑出血后癫痫发作患者的出血部位、侧别、病因等临床特点。结果 共入组2836例脑出血患者,其中脑出血后伴发癫痫发作者106例,无癫痫发作者2730例。与脑出血后无癫痫发作组患者相比,脑出血后癫痫发作患者年龄较小[（50±17）岁 vs（55±15）岁,P <0.001],合并高血压者比例较低（60.4％ vs 86.9％,P <0.001）,合并肺部感染比例较高（42.5%vs 28.5%,P =0.003）。进一步分析脑出血后癫痫发作组脑出血特点,发现脑叶出血比例较高（57.3%）,且非高血压性脑出血比例较高（59.0%）。结论 与脑出血后无癫痫发作患者比较,脑出血后癫痫发作患者年龄较小,合并合并高血压的比例低,住院期间肺部感染比例高;脑出血后癫痫发作患者出血多位于脑叶,多为非高血压性脑出血。

Clinical Characteristics Analysis of Patients with Epilepsy Seizure after Cerebral Hemorrhage

Objective To analyze the clinical characteristics of patients with epileptic seizure after cerebral
hemorrhage.
Methods This is a retrospective study. Patients with cerebral hemorrhage (within 14 days
of onset) and without history of epilepsy from Beijing Tian Tan Hospital from 2009 to 2018
were consecutively enrolled in this study. According to whether there is epilepsy seizure after
hemorrhage, the patients were divided into epilepsy group and no epilepsy group. Baseline data, the
lesion location and cause of cerebral hemorrhage of the two groups were compared to analyze the
related factors of epilepsy seizure after cerebral hemorrhage.
Results A total of 2836 hemorrhage patients were included in this study, with 106 cases in epilepsy
group and 2730 cases in no epilepsy group. Compared to no epilepsy group, epilepsy group had more
younger age [(50±17) years vs (55±15) years, P <0.001)], and higher incidence of lung infection (42.5%
vs 28.5%, P =0.003). And complication of hypertension (60.4% vs 86.9%, P <0.001) is less in epilepsy
group than that in no epilepsy group. In epilepsy group, most lesions of hemorrhage were located in
the lobes (57.3%), and the main cause of hemorrhage was non-hypertensive (59.0%).
Conclusions Compared to the patients without epilepsy seizure after hemorrhage, the patients
occurring epilepsy after hemorrhage tended to be younger, and have lower rate of hypertension
complication and higher rate of lung infection in hosptal. The most common bleeding lesions in
patients with epilepsy seizure after hemorrhage were located in the lobes, and the main cause of
hemorrhage in these patients was non-hypertensive.