儿童癫痫治疗后复发的临床特点及EEG特征分析  

Clinical Characteristics and EEG Features of Recurrence in Pediatric Epilepsy After Treatment

作　　者：王立利[1] 王维[1] WANG Lili;WANG Wei(Department of Pediatrics,Tangshan Maternal and Child Health Hospital,Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院儿内科,河北唐山063000

出　　处：《神经损伤与功能重建》2025年第3期144-149,共6页Neural Injury and Functional Reconstruction

摘　　要：目的:探究儿童癫痫治疗后复发的临床特点并对癫痫儿童发作间期的脑电图(EEG)进行特征分析。方法:回顾性分析本院收治的癫痫儿童168例,根据随访结果分为复发组(n=64)和未复发组(n=104)。采用多因素Logistic回归模型分析影响患儿预后复发的独立影响因素,EEG各参数与癫痫复发临床特征间的相关性。采用贝叶斯网络构建患儿癫痫复发的预测模型。通过Kaplan-Meier生存曲线模型绘制随访期间复发积累曲线图,分析患儿随访期间复发情况。结果:男性、神经功能障碍、睡眠障碍、发作至有效控制时间>1年、发病频率>5次/年、MRI结果显示头颅有病灶、FAT1表达阴性、焦虑为患儿复发的独立危险因素(P<0.05)。减药前无发作时间≥5年、减药时间>6个月、病始年龄3~14岁、停药后的α段、θ段、δ段为患儿复发的独立保护因素(P<0.05)。停药后复发组患儿α、θ、δ波与未复发组患者相比更低(P<0.05)。减药时间与α段、θ段、δ段的频率呈显著正相关(P<0.05),睡眠障碍、发作至有效控制时间、发作频率、神经功能障碍与α段、θ段、δ段的频率呈显著负相关(P<0.05)。大部分患儿复发集中在治疗后24个月内。结论:男性、神经功能障碍、睡眠障碍、发作至有效控制时间>1年、发病频率>5次/年、MRI结果显示头颅有病灶、FAT1表达阴性、焦虑为患儿复发的独立危险因素。减药前无发作时间≥5年、减药时间>6个月、病始年龄3~14岁、停药后的α段、θ段、δ段为患儿复发的独立保护因素。Objective:To explore the clinical characteristics of recurrence in pediatric epilepsy after treatment and analyze the electroencephalogram(EEG)features during the interictal period in epileptic children.Methods:A retrospective analysis was conducted on 168 pediatric patients with epilepsy admitted to our hospital.The patients were divided into a recurrence group(n=64)and a non-recurrence group(n=104)based on follow-up results.A multivariate Logistic regression model was used to analyze the independent influencing factors of prognosis recurrence in the patients,as well as the correlation between EEG parameters and clinical characteristics of epilepsy recurrence.A Bayesian network was employed to construct a prediction model for epilepsy recurrence in the patients.The Kaplan-Meier survival curve model was utilized to draw the cumulative recurrence curve during the follow-up period and analyze the recurrence situation of the patients during the follow-up.Results:Male gender,neurological dysfunction,sleep disorders,time to effective control exceeding one year,seizure frequency exceeding five times per year,MRI showing intracranial lesions,negative FAT1 expression,and anxiety were identified as independent risk factors for recurrence in the patients(P<0.05).Independent protective factors for recurrence included no seizure for at least five years before medication reduction,medication reduction duration exceeding six months,age of onset between 3 and 14 years,andα,θ,andδbands after medication withdrawal(P<0.05).Theα,θ,andδwaves were lower in the recurrence group compared to the non-recurrence group after medication withdrawal(P<0.05).There was a significant positive correlation between medication reduction duration and the frequencies ofα,θ,andδbands(P<0.05),while sleep disorders,time to effective control,seizure frequency,and neurological dysfunction were significantly negatively correlated with the frequencies ofα,θ,andδbands(P<0.05).Most recurrences occurred within 24 months after treatment.Conclusion:Ma

关 键 词：癫痫 儿童 脑电图 复发 贝叶斯网络 

分 类 号：R741[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]