急性脑梗死患者继发癫痫临床特征及危险因素分析  

Clinical features and risk factors of secondary epilepsy in patients with acute cerebral infarction

作　　者：赵宇[1] 王展[1] ZHAO Yu;WANG Zhan(Department of Neurology,Tanghe County People's Hospital,Nanyang,Henan 473400,China)

机构地区：[1]唐河县人民医院神经内科,河南南阳473400

出　　处：《中国医学工程》2024年第11期87-90,共4页China Medical Engineering

摘　　要：目的探讨急性脑梗死继发癫痫患者临床特征及相关危险因素,旨在为早期发现癫痫继发高危人群及指导临床防治方案制定提供更多参考。方法回顾性纳入2019年1月至2022年12月唐河县人民医院诊治的急性脑梗死患者共203例,根据是否继发癫痫分为癫痫组(33例)和无癫痫组(170例),比较两组人口学资料、合并基础疾病、梗死病变情况及实验室检查指标,采用Logistic回归模型多因素法评价急性脑梗死继发癫痫独立危险因素。结果研究纳入急性脑梗死患者203例中继发癫痫33例,发生率为16.26%。两组梗死范围、局部血容量、局部血流量、白细胞计数水平、中性粒细胞计数水平及可溶性白细胞介素-2受体水平比较,差异有统计学意义(P<0.05);将单因素分析差异有统计学意义的指标纳入Logistic回归模型行多因素分析,结果显示皮层梗死、低局部血容量、低局部血流量、高白细胞计数水平、高中性粒细胞计数水平及高可溶性白细胞介素-2受体水平均是急性脑梗死继发癫痫的独立危险因素(P<0.05)。结论急性脑梗死继发癫痫与梗死范围、脑部血流灌注情况及免疫炎症相关实验室指标等有关;其中皮层梗死、低局部血容量、低局部血流量、高白细胞计数水平、高中性粒细胞计数水平及高可溶性白细胞介素-2受体水平患者更易继发癫痫。【Objective】To investigate the clinical features and related risk factors of patients with epilepsy secondary to acute cerebral infarction to provide more reference for early detection of high-risk groups of secondary epilepsy and guiding the formulation of clinical prevention and treatment plans.【Methods】A total of 203 patients with acute ischemic stroke were retrospectively chosen in the period from January 2019 to December 2022.All patients were divided into epileptic group(33 cases)and non-epileptic group(170 cases)according to whether they had secondary epilepsy.The demographic data,combined underlying diseases,infarct lesions and laboratory examination indicators were compared between the two groups,and the independent risk factors of secondary epilepsy after acute ischemic stroke were evaluated by multifactor method with logistic regression model.【Results】Thirty-three cases had secondary epilepsy accounting for 16.26%in all 203 patients with acute ischemic stroke.There were significant differences in infarct range,local blood volume,local blood flow,white blood cell count,neutrophil count and soluble interleukin-2 receptor level between the two groups(P<0.05).Logistic regression model was used for multivariate analysis.The results showed that cortical infarction,low local blood volume,low local blood flow,high white blood cell count,high neutrophil count and high soluble interleukin-2 receptor level were independent risk factors for secondary epilepsy after acute ischemic stroke(P<0.05).【Conclusion】The secondary epilepsy of acute ischemic stroke is related to the infarct scope,cerebral blood perfusion and laboratory indexes related to immune inflammation.Patients with cortical infarction,low local blood volume,low local blood flow,high white blood cell count,high neutrophil count and high soluble interleukin-2 receptor level were more likely to have secondary epilepsy.

关 键 词：急性脑梗死 癫痫 危险因素 免疫炎症反应 

分 类 号：R742.1[医药卫生—神经病学与精神病学]