局灶性癫痫患者发作期心率差值危险因素分析  

Clinical research of risk factors for ictal heart rate changes in focal epilepsy

作　　者：王凤芸 石国锋[1] 程卫国 徐敏[1] Wang Fengyun;Shi Guofeng;Cheng Weiguo;Xu Min(Department of Neurology,Wuxi People's Hospital,Wuxi City,Jiangsu Province,214000,China)

机构地区：[1]无锡市人民医院神经内科,江苏省无锡市214000

出　　处：《现代电生理学杂志》2021年第4期195-200,共6页Journal of Modern Electrophysiology

摘　　要：目的:通过视频脑电-心电监测,分析局灶性癫痫患者发作期心率差值的危险因素。方法:回顾性分析无锡市人民医院癫痫诊疗中心行长程视频脑电图监测的54例局灶性癫痫患者,183次临床发作的视频脑电-心电监测资料,包括简单部分性发作(SPS)25次,复杂部分性发作(CPS)44次,部分继发全面性发作(CPS-G)114次。记录视频脑电-心电监测下的局灶性癫痫患者安静状态下基础心率(每次脑电发作起始前5分钟)、发作期最大心率,计算发作期心率差值(发作期最大心率与基础心率的差值)。分析性别、年龄、睡眠/清醒状态、部位、侧别、发作类型、癫痫病程、发作频率、抗癫痫药物数量、病因等对局灶性癫痫发作期心率差值的影响。结果:成人(≥18岁)较未成年人(<18岁)心率差值大(P<0.001);睡眠期发作较清醒期发作心率差值大(P<0.05);不同发作类型,心率差值具有统计学意义(P<0.001),CPS-G较CPS、SPS心率差值明显增大(P<0.001);癫痫病程≥5年的心率差值高于癫痫病程<5年心率差值(P<0.05)。局灶性癫痫发作期心率差值与年龄呈正相关(r=0.312,P<0.001),通过线性回归分析得出年龄和发作类型是局灶性癫痫发作期心率差值的独立危险因素。结论:年龄、睡眠期、部分继发全面性发作、癫痫病程持续时间长对局灶性癫痫患者发作期心率差值有影响,其中,年龄、部分继发全面性发作是局灶性癫痫发作期心率差值的独立危险因素。Objective: To analyze the risk factors of heart rate changes in patients with focal epilepsy by video-EEG-ECG monitoring. Methods: The video-EEG-ECG monitoring data of 54 patients with focal epilepsy monitored by video-EEG in the epilepsy diagnosis and treatment center of Wuxi People’s Hospital were analyzed retrospectively, including 25 simple partial seizures(SPS), 44 complex partial seizures(CPS) and 114 complex partial seizures followed by generalized seizures(CPS-G). Record the basic heart rate(5 minutes before the beginning of each EEG attack) and the maximum heart rate during the attack of focal epilepsy patients under video-EEG-ECG monitoring, and calculate the heart rate difference during the attack(the difference between the maximum heart rate during the attack and the basic heart rate). The effects of gender, age, sleep/awake state,location, side, seizure type, epilepsy course, seizure frequency, numbers of antiepileptic drugs and etiology on heart rate difference during their epilepsy coming on. Results: Adults( ≥ 18 years old) have a larger heart rate change than minors(<18 years old)(P<0.001). The heart rate change of sleep attack was greater than that of awake attack(P<0.05). The heart rate difference of CPS-G was significantly higher than that of CPS and SPS(P<0.001). The heart rate difference of epilepsy course ≥5 years was higher than that of epilepsy course<5 years(P<0.05). The ictal heart rate change was positively correlated with age(r=0.312, P<0.001). Through linear regression analysis, it was concluded that age and seizure type were independent risk factors of ictal heart rate changes. Conclusion: Age,sleep period, CPS-G and long duration of epilepsy have influence on the heart rate changes of focal epilepsy, among which, age and CPS-G are independent risk factors for heart rate changes of focal epilepsy.

关 键 词：癫痫 部分性 脑电描记术 心率 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]