影响脑梗死继发癫痫患者预后因素的临床研究  

Clinical study on factors affecting prognosis of patients with epilepsy secondary to cerebral infarction

作　　者：晏玉奎[1] 周玮[2] 胡建琴[1] 张冰[1] YAN Yukui;ZHOU Wei;HU Jianqin;ZHANG Bing(Department of Neurology,Huzhou Central Hospital of Zhejiang Province,Affiliated Hospital of Huzhou Normal University,Huzhou 313000,China;Department of Radiology,Huzhou Central Hospital of Zhejiang Province,Affiliated Hospital of Huzhou Normal University,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院湖州师范学院附属中心医院神经内科,浙江湖州313000 [2]浙江省湖州市中心医院湖州师范学院附属中心医院放射科,浙江湖州313000

出　　处：《中国现代医生》2021年第36期53-56,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2016ZHB022);浙江省湖州市科学技术局公益性应用研究项目(2020GY14)。

摘　　要：目的探讨影响脑梗死继发癫痫患者预后的因素。方法采用回顾性研究方法,选取2015年10月至2020年10月就诊于我院脑梗死继发癫痫的患者198例作为研究对象,根据癫痫患者是否达到2年无临床发作,分为预后良好组120例和预后不佳组78例,进一步总结患者的脑电图、头颅MR及临床资料,通过单因素、多因素Logistic回归分析,分析影响癫痫患者预后的因素。结果单因素Logistic回归分析显示,部分性癫痫发作类型(OR=2.11,P<0.05)、脑电图癫痫样波异常(OR=1.98,P<0.05)、MR病灶累及皮质(OR=4.51,P<0.05)及多药物联合治疗(OR=1.98,P<0.05)是患者预后不佳的因素。多因素Logistic回归分析显示,MR病灶累及皮质(OR=3.05,P<0.05)、多药物联合治疗(OR=1.79,P<0.05)是患者预后不佳的因素。结论头颅MR病灶部位以及多药联合治疗,是脑梗死继发癫痫患者预后不佳的危险因素,为临床提供治疗方案,具有一定参考价值。Objective To investigate the factors affecting the prognosis of patients with epilepsy secondary to cerebral infarction.Methods A retrospective research method was used to select 198 patients with epilepsy secondary to cerebral infarction treated in our hospital from October 2015 to October 2020.According to whether the patients had clinical epilepsy in 2 years,they were divided into the good prognosis group and the poor prognosis group,with 120 and 78 patients,respectively.The EEG,head MR and clinical data of patients were summarized,to analyze the factors affecting the prognosis of patients with epilepsy using single-factor and multi-factor Logistic regression.Results Single-factor Logistic regression analysis showed that partial epilepsy type(OR=2.11,P<0.05),EEG epileptiform abnormalities(OR=1.98,P<0.05),MR lesions in the cortex(OR=4.51,P<0.05)and multi-drug combination therapy(OR=1.98,P<0.05)were the factors for poor prognosis.Multi-factor Logistic regression analysis showed that MR lesions in the cortex(OR=3.05,P<0.05)and multi-drug combination therapy(OR=1.79,P<0.05)were the factors for the poor prognosis.Conclusion The location of cranial MR lesion and multi-drug combination therapy are risk factors for poor prognosis in patients with epilepsy secondary to cerebral infarction.It has certain reference value in clinical treatment.

关 键 词：脑梗死 癫痫 磁共振成像 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]