对癫痫无发作患者停用抗癫痫药物之前脑电图异常放电的独立风险因素进行分析  

Analysis of Independent Risk Factors for Abnormal EEG Discharge in Seizure-free Patients before Stopping Anti-epileptic Drugs

作　　者：张锋 ZHANG Feng(Department of Neuroelectrophysiology,Special Examination Department,Heze Municipal Hospital,Heze,Shandong Province,274000 China)

机构地区：[1]山东省菏泽市市立医院特检科神经电生理,山东菏泽274000

出　　处：《世界复合医学》2021年第3期1-3,7,共4页World Journal of Complex Medicine

摘　　要：目的探析癫痫无发作患者停用抗癫痫药物之前脑电图异常放电的独立风险因素,并探讨经长程脑电图预测对癫痫无发作患者停服药物之后出现复发的风险产生的价值。方法选择2015年1月—2017年1月于该院采取抗癫痫药物治疗,且癫痫无发作3年以上的54例患者作为研究对象。在对其进行减服药物以及停服药物之前进行长程脑电图监测,并在停服药物之后随访2~3年。将存在癫痫样放电的患者列为癫痫组,未出现癫痫样放电的患者列为非癫痫组,对比两组减服药物或停服药物1年、2~3年的复发率。结果停药之前,存在癫痫样放电的患者共18例,癫痫样放电率为33.33%,未出现癫痫样放电患者共36例;患者减服药物或停服药物1年内,癫痫组出现5例复发,复发率为27.78%,非癫痫组出现3例复发,复发率为8.33%;患者减服药物或停服药物2~3年,癫痫组出现2例复发,复发率为11.11%,非癫痫组出现2例复发,复发率为5.56%。癫痫组的总复发率为38.89%,非癫痫组的总复发率为13.89%。癫痫组的总复发率高于非癫痫组,差异有统计学意义(χ^(2)=14.237,P<0.05)。结论采用抗癫痫药物进行治疗后>3年,癫痫无发作患者无论减服药物还是停服药物之前其长程脑电图监测是否存在异常,其均存在癫痫复发率,但脑电图出现异常放电的患者在减服药物或是停服药物之后,其复发率比较高,说明停药之后存在的复发风险比较大,也说明在对癫痫无发作患者停药之后预估复发风险过程中,应用长程脑电图检测具有较高的价值,值得推广。Objective To analyze the independent risk factors of abnormal EEG discharge in seizure-free patients before stopping antiepileptic drugs,and to explore the value of long-term EEG prediction for the risk of recurrence in seizure-free patients after stopping the drug.Methods 54 patients who were treated with antiepileptic drugs in the hospital from January 2015 to January 2017 and who had no seizures for more than 3 years were selected as the research objects.Long-term EEG monitoring was carried out before the drug was reduced and the drug was stopped,and the follow-up was 2 to 3 years after the drug was stopped.Patients with epileptiform discharges were classified as epilepsy group,and patients without epileptiform discharges were classified as non-epilepsy group,and the recurrence rates of the two groups were compared for 1 year and 2 to 3 years after reducing the medication or stopping the medication.Results Before stopping the drug,there were 18 patients with epileptiform discharges,the epileptiform discharge rate was 33.33%,and there were 36 patients without epileptiform discharges.Within 1 year of reducing or stopping the medication,there were 5 recurrences in the epilepsy group,with a recurrence rate of 27.78%,and 3 recurrences in the non-epilepsy group,with a recurrence rate of 8.33%;the patients reduced their medication or stopped taking the medication 2~3,there were 2 recurrences in the epilepsy group,with a recurrence rate of 11.11%,and 2 recurrences in the non-epilepsy group,with a recurrence rate of 5.56%.The total recurrence rate of the epilepsy group was 38.89%,and the total recurrence rate of the non-epilepsy group was 13.89%.The total recurrence rate of the epilepsy group was higher than that of the non-epilepsy group.The difference was not statistically significant(χ^(2)=14.237,P<0.05).Conclusion After treatment with antiepileptic drugs for more than 3 years,patients with seizure-free epilepsy regardless of whether the drug is reduced or stopped,whether the long-term EEG monitoring is abnormal be

关 键 词：癫痫无发作 抗癫痫药物 长程脑电图 异常放电 独立风险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]