自发性蛛网膜下腔出血继发癫痫发作的相关因素研究  

Relevant Factors of Seizures after Spontaneous Subarachnoid Hemorrhage

作　　者：李继华[1] 崔永鹏[1] 刘宝军[1] 裴斐[1] 杨娜[2] 

机构地区：[1]河北联合大学附属开滦总医院神经外科,河北省唐山市063000 [2]河北联合大学附属开滦总医院神经内科,河北省唐山市063000

出　　处：《中国全科医学》2013年第12期1336-1338,共3页Chinese General Practice

摘　　要：目的探讨自发性蛛网膜下腔出血(SAH)继发癫痫发作的相关因素。方法回顾性分析2002年1月—2012年9月河北联合大学附属开滦总医院收治的158例自发性SAH的临床资料。包括性别构成,年龄,体质指数,吸烟、饮酒情况,高血压、糖尿病、冠心病、脑梗死发生情况,格拉斯哥昏迷量表评分(GCS)、Fisher评分和Hunt-Hess评分(HHS)。并将可能继发癫痫的相关因素进行多因素非条件Logistic回归分析。结果 158例自发性SAH患者中23例继发癫痫发作,发生率为14.6%(23/158)。经单因素分析,其中癫痫组饮酒率及脑梗死、GCS 3～8分、Fisher评分3～4分的发生率与非癫痫组比较,差异均有统计学意义(P<0.05)。多因素非条件Logistic回归分析显示,Fisher评分3～4分〔OR=1.778,95%CI(1.069,2.678),P=0.046〕、脑梗死〔OR=3.124,95%CI(1.221,7.184),P=0.012〕进入回归方程。结论较高的Fisher评分和脑梗死史是自发性SAH继发癫痫发作的危险因素,对于Fisher评分较高和(或)有脑梗死史的患者给予预防性抗癫痫治疗可能会更好地预防癫痫发作。Objective To investigate the relevant factors of seizures after spontaneous subarachnoid hemorrhage （SAH） . Methods A total of 158 patients with spontaneous SAH were enrolled in this ten year retrospective study, including the sex ratio, age, body mass index, smoking, drinking, hypertension, diabetes mellitus, coronary disease history, brain infarction history, Glasgow Coma Scale, Fisher scale and Hunt - Hess scale. Possible relevant factors for seizure were analyzed by using multiple factor Logistic regression analysis. Results Seizures occurred in 23 patients who had SAH, accounting for 14. 6% （23/158） . According to single factor analysis, the incidence of drinking, brain infarction, Glasgow Coma Scale （3 - 8 scale） and Fisher scale （3 - 4 scale） between epileptic group and non -epileptic group all had statistically significant differences （P 〈 0. 05 ） . Multiple factor unconditional Logistic regression analysis showed that Fisher scale （ 3 - 4 scale） [ OR = 1. 778, 95 % CI （1.069, 2.678） , P=0.0463 and brain infarction [OR=3. 124, 95%CI （1.221, 7. 184）, P=0.0123 entered the regression equation. Conclusion Higher Fisher scale and history of brain infarction are predictive of seizure. Fine prognosis probably will be achieved if the patients with higher Fisher scale and （or） history of brain infarction accept anti - epileptic treatment.

关 键 词：蛛网膜下腔出血 癫痫 危险因素 预后 

分 类 号：R742.1[医药卫生—神经病学与精神病学]