老年惊厥性癫痫持续状态临床分析及死亡危险因素研究  

Clinical characteristics of elderly convulsive status epilepticus patients and risk factors for their death

作　　者：时霄冰[1] 柏秀娟[1] 郭艳娥[1] 王淼[1] 解恒革[1] 姜磊[1] Shi Xiaobing;Bai Xiujuan;Guo Yan'e;Wang Miao;Xie Hengge;Jiang Lei(Department of Neurology,Chinese PLA General Hospital No.2 Medical Center,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心神经内科国家老年疾病临床医学研究中心,北京100853

出　　处：《中华老年心脑血管病杂志》2022年第5期499-502,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家重点研发计划(2019YFC0118201)。

摘　　要：目的 分析老年惊厥性癫痫持续状态(SE)的临床特点及影响预后的相关因素。方法 回顾性分析2005年1月~2020年8月在我院神经内科住院治疗的老年惊厥性SE患者41例,采用癫痫持续状态严重程度评分(STESS)进行评估,进行1年以上长期随访,观察患者并发症、近期(1个月内)和远期(1年)预后。结果 本研究10例惊厥性SE治疗后1年以上无发作,4例惊厥性SE治疗后仍有频繁发作;惊厥性SE并发肺炎9例,气管插管机械通气7例;近期死亡7例,远期死亡23例。远期死亡患者合并心肺等主要器官疾病种数及惊厥性SE并发症种数明显多于远期生存患者(P<0.01)。多因素logistic回归分析显示,惊厥性SE并发症种数是远期死亡的独立危险因素(95%CI:0.011~0.904,P=0.040)。结论 老年惊厥性SE病死率高,惊厥性SE并发症种数是远期预后的独立危险因素。由于年龄因素的影响,STESS在老年CSE危险因素分析中存在局限性。Objective To analyze the clinical characteristics of elderly convulsive status epilepticus(CSE) patients and the risk factors for their outcomes.Methods Fourty-one elederly CSE patients admitted to our hospital from January 2005 to August 2021 were included in this study.Their CSE was assessed according to their status epilepticus severity score(STESS).The patients were followed up for ≥1 year, during which the incidence of complications, short-term(within 1 month) and long-term(1 year) outcomes were recorded.Results Of the 41 CSE patients included in this study, 10 had no attack of CSE,4 had frequent attack of CSE,9 devolped complicated pneumonia and 7 underwent tracheal intubation for mechanical ventilation, 7 died during the shorterm follow-up period and 23 died during the long-term follow-up period.The number of patients with cardiopulmonary and other major organ diseases and the number of CSE complications were significantly greater in patients who died during the long-term follow-up period than in those who survived during the long-term follow-up period(P<0.01).Multivariate logistic regression analysis displayed that complications of CSE were an independent risk factor for death in elderly CSE patients during the long-term follow-up period(95%CI:0.011-0.904,P=0.040).Conclusion The death rate is high in elderly CSE patients.Complications of CSE are an independent risk factor for death in elderly CSE patients during the long-term period.STESS plays a limited role in analyzing the risk factors for CSE in elderly CSE patients.

关 键 词：癫痫 癫痫持续状态 抗惊厥药 死亡率 年龄因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]