缺血性卒中后癫痫发作复发和耐药的预测因素  

Predictors of recurrence and drug resistance of seizures after ischemic stroke

作　　者：赵薛斌 赵合庆[1] 邹蓉[1] 张忠文[1] 胡伟东[1] 

机构地区：[1]215004,苏州大学附属第二医院神经内科

出　　处：《国际脑血管病杂志》2016年第2期163-167,共5页International Journal of Cerebrovascular Diseases

基　　金：苏州市科技发展计划（SYS201549）

摘　　要：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。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.

关 键 词：卒中 脑缺血 癫痫发作 抗惊厥药 抗药性 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]