成人首次非诱发性癫痫发作复发相关因素分析  

Analysis of the factors associated with seizure recurrence after a first unprovoked seizure in adults

作　　者：肖远流 陈宗梅[1] 秦锡祥[1] 曹柱[1] 吴锡芬[1] 陆文欣[1] 陈子怡[2] XIAO Yuanliu;CHEN Zongmei;QIN Xixiang;CAO Zhu;WU Xifen;LU Wenxin;CHEN Ziyi(Department of Neurology,National Key Clinical Department and Key Discipline of Neurology,the First Affiliated Hospital,Sun Yat-sen University,58th,Zhongshan 2nd Road,510080)

机构地区：[1]广东省廉江市人民医院神经内科,廉江524400 [2]中山大学附属第一医院神经内科

出　　处：《中国神经精神疾病杂志》2018年第5期257-260,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨成人首次非诱发癫痫发作1年内复发的影响因素。方法纳入成人首次非诱发性癫痫发作的患者159例,分为复发组(n=54)和非复发组(n=105)两组,收集患者的性别、发病年龄、颅脑损伤史、脑电图、脑部影像学、发作时间、癫痫发作形式、合并糖尿病、高血压病、冠心病、高脂血症等疾病的临床资料,分析首次癫痫发作后复发的相关因素。结果多因素Logistic回归分析,发现有脑损伤史(P=0.033,OR=5.547)、发病时间晚上(P=0.001,OR=33.660)、影像学显示病灶在皮质(P=0.004,OR=14.865)为复发的独立危险因素。结论成人首次非诱发性癫痫发作的患者若既往有颅脑损伤史、脑皮质影像学异常、睡眠中发作其1年内复发风险可能较高。Objective To explore the influence factors of recurrence after a first unprovoked seizure in adults within 1 year. Methods One hundred fifty-nine adult patients with first unprovoked seizure were recruited in the study.Patients were then divided into the relapse group（n=54） and the relapse group（n=105）. Statistic analysis was performed on the clinical data including gender, age, history of traumatic brain injury, electroencephalogram（EEG） and brain imaging, the form of attack time, seizures, diabetes mellitus, hypertension, coronary heart disease, hyperlipidemia disease.Results Multiariable Logistic regression analysis found that history of brain injury（P=0.033, OR=5.547）, period（P=0.001, OR=33.660） in the evening, cortical lesions（P=0.004, OR=14.865） were independent risk factors for recurrence.Conclusions Adult patients with first unprovoked seizure have a high risk of one-year recurrence if the patients have a history of traumatic brain injury, the radiographic abnormalities, cortical lesions and sleep attacks.

关 键 词：首次发作 癫痫 复发 相关因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]