耐药性癫痫的相关危险因素分析  

Clinical Characters of Drug Resistant Epilepsy

作　　者：胡春霞[1] 郑维红[1] 刘肇绩[1] 张岱威[1] 

机构地区：[1]厦门大学附属中山医院神经内科,福建厦门361004

出　　处：《医学综述》2015年第14期2642-2644,共3页Medical Recapitulate

基　　金：2011年福建省卫生厅青年课题(2011-2-67);2012厦门市科技指导性项目(2011S0351)

摘　　要：目的探讨癫痫患者发生耐药性的相关危险因素。方法收集2005年12月至2012年1月在厦门大学附属中山医院神经内科门诊和住院治疗的耐药性癫痫和控制良好癫痫患者各46例,比较两者在病程、发作类型、病灶、颞叶起源、脑炎病史等指标间的差异,并用Logistic回归研究相关差异指标评估有无病灶的耐药性癫痫患者的价值。结果 Logistic回归分析结果显示,有颞叶起源异常放电(P=0.011)、是否有颅内病灶(P=0.044)以及具有脑炎病史(P=0.040)是耐药性的危险因素,总病程(P=0.012)和有颞叶起源放电(P=0.015)是无病灶癫痫患者耐药性的危险因素。结论临床上针对有颅内病灶、颞叶起源异常放电和脑炎病史的癫痫患者,需考虑耐药性癫痫的可能,以早期干预,早期规范治疗,避免耐药性发生。Objective To identify the related risk predictors of refractory epilepsy.Methods This study enrolled 46 epilepsy patients with drug resistance and 46 matched controls with well controlled epilepsy who had been treated in Zhongshan Hospital of Xiamen University from Dec.2005 to Jan.2012.Clinical fea-tures including illness course,type of attack,lesion,temporal lobe,and encephalitis case between patients with drug-resistant epilepsy and patients with well-controlled epilepsy were compared,and the indexes were evaluated for assessment of lesion existence of the epilepsy patients by Logistic regression analysis .Results Logistic regression analysis showed that：the abnormal discharge of temporal lobe origin（P =0.011）,exist-ence of intracranial lesions（P=0.044） and history of encephalitis（P =0.040） were risk factors for drug-resistance,total course of disease （ P =0.012 ） and temporal lobe origin discharge （ P =0.015 ） were risk factors for drug resistance of non-focal seizures patients.Conclusion The possibility of progress to drug resistant epilepsy should be considered for patients who have intracranial lesions , temporal lobe origin of abnormal discharge and encephalitis history.Early intervention and standardized treatment may avoid the occurrence of drug resistance.

关 键 词：耐药性癫痫 临床特点 LOGISTIC回归 

分 类 号：R742.1[医药卫生—神经病学与精神病学]