脑梗死患者继发性癫痫发生情况及高危因素调查
Investigation on the Secondary Epilepsy Occurrence of Patients with Cerebral Infarction and Its Risk Factors
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摘要: 目的 观察脑梗死患者继发性癫痫的发生情况, 探讨影响患者继发性癫痫的高危因素.方法 选择攀枝花市中心医院2016年4月至2017年8月确诊的脑梗死继发性癫痫患者84例为观察组, 同时选择同一时期脑梗死未发生癫痫的84例患者作为对照组.随访继发性癫痫发作的情况, 记录患者的一般资料、基础疾病、高血压分级、血电解质、病灶位置、病灶直径等, 筛选脑梗死继发性癫痫的危险因素, 分析继发性癫痫发生情况.结果 (1) 继发性癫痫患者发作类型:部分发作69例, 全面发作15例;发病时间:早发性60例, 迟发性24例; (2) 2组患者一般资料、基础疾病、病灶直径、高血压分级等数据比较, 差异无统计学意义 (P>0.05) , 2组患者病灶位置及病变具体位置构成、血电解质水平比较, 差异具有统计学意义 (P<0.05) , 非条件多因素Logistic回归分析结果显示:梗死部位累及皮质、颞叶、血清氯值与继发性癫痫的发生具有相关性 (P<0.05) ; (3) 多因素Logistic回归分析结果显示:梗死部位累及皮质 (OR=3.10, P=0.004, 95%CI=1.527.41) 、梗死位于颞叶 (OR=2.98, P=0.012, 95%CI=1.327.35) 、血清氯值 (OR=1.25, P=0.017, 95%CI=1.001.38) 是脑梗死继发性癫痫的高危因素.结论 脑梗死继发性癫痫以部分发作和早发性发作最为常见, 梗死部位累及皮质、位于颞叶、血清氯值是脑梗死患者继发性癫痫的高危因素, 应采取必要的措施对继发性癫痫发生的高危因素进行干预, 提高患者的临床生命质量.Abstract: Objective To observe the incidence of secondary epilepsy in patients with cerebral infarction and explore the risk factors of secondary epilepsy. Me thods Eighty-four patients with secondary epilepsy diagnosed as cerebral infarction from April 2016 to August 2017 in our hospital were selected as the observation group, and 84 patients of cerebral infarction without epilepsy in the same period were selected as the control group. Follow-up of secondary epileptic seizures, the general information of patients, basic diseases, hypertension grade, blood electrolytes, lesion location, diameter of lesion were recorded, and the risk factors of secondary epilepsy in cerebral infarction were screened, and the status of secondary epilepsy were analyzed. Re s ults (1) The types of epilepsy in secondary epilepsy: partial seizure in 69 cases, complete attack in 15 cases; onset time: early onset in 60 cases, late in 24 cases. (2) There was no significant difference between the two groups in general information, underlying disease, lesion diameter and grade ofhypertension (P>0.05) . The differences statistically significento significance in the consist of lesion location and lesion specific location and blood electrolyte levels (P <0.05) .Unconditional multivariate logistic regression analysis showed thoao infarction involving the cortex, temporal lobe, and serum chloride value was correlated with the occurrence of secondary epilepsy (P<0.05) . (3) MultivariateLogistic regression analysis showed tthat infaretion involving the cortex (OR = 3.10, P = 0.004, 95% CI =1.52-7.41) , locating in the temporal lobe, (OR = 2.98, P = 0.012, 95% CI = 1.32-7.35) and serum chlorine (OR = 1.25, P = 0.017, 95% CI = 1.00-1.38) were the risk factors for secondary epilepsy in cerebral infarction.Conclusions Partial and early onset of seizures are the most common in cerebral infarction secondary epilepsy.Infarction involving the cortex, locating in the temporal lobe and serum chlorine are the risk factors for secondary epilepsy in patients with cerebral infarction. Necessary measures should be taken to intervene at high risk of secondary epilepsy and to improve the clinical quality of life of patients.
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Key words:
- Secondary epilepsy /
- Cerebral infarction /
- High risk factors /
- Involving in the cortex /
- Serum chloride
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