脑卒中后癫痫持续状态复发情况及其危险因素分析  

Analysis of Recurrent of Status Epilepticus after Stroke and Its Risk Factors

作　　者：鞠强国 张华 周仁华[1] 沈骏[1] 姜宇[1] 徐建红[1] 侍永伟 JU Qiangguo;ZHANG Hua;ZHOU Renhua;SHEN Jun;JIANG Yu;XU Jianhong;SHI Yongwei(Taizhou Fourth People's Hospital,Taizhou 225300,China;不详)

机构地区：[1]泰州市第四人民医院,江苏泰州225300

出　　处：《中外医学研究》2025年第7期104-107,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：泰州市科技支撑计划(社会发展)非企立项项目(TN202114)。

摘　　要：目的:研究脑卒中后癫痫持续状态复发情况及其危险因素。方法:回顾性分析2018年1月—2023年7月泰州市第四人民医院收治的80例脑卒中后癫痫持续状态患者的临床资料。分析患者复发情况,统计患者年龄、性别、病程、基础疾病、体重指数(BMI)、吸烟史、饮酒史、入院时改良Rankin量表(mRS)评分、周期性癫痫样放电、肺部感染、卒中类型(缺血性脑卒中、出血性脑卒中)、病灶部位(皮质、皮质下)、病灶范围(多脑叶、单脑叶)、入院时美国国立卫生研究院卒中量表(NIHSS)评分等一般资料,以logistic多因素回归分析法分析影响脑卒中后癫痫持续状态复发的危险因素。结果:80例脑卒中后癫痫持续状态患者中,有14例(17.50%)复发,纳为复发组;其余66例(82.50%)未复发,纳为未复发组。两组年龄、性别、病程、基础疾病、BMI、吸烟史、饮酒史、入院时mRS评分比较,差异无统计学意义(P>0.05)。复发组周期性癫痫样放电、肺部感染、出血性脑卒中、皮质、多脑叶占比及NIHSS评分均高于未复发组,差异有统计学意义(P<0.05)。经logistic回归分析显示,周期性癫痫样放电、入院时NIHSS评分、卒中类型、病灶部位、肺部感染是影响脑卒中后癫痫持续状态患者复发的独立危险因素(P<0.05)。结论:脑卒中后癫痫持续状态患者复发与周期性癫痫样放电、入院时NIHSS评分、卒中类型、病灶部位、肺部感染密切相关。Objective:To study the recurrence of status epilepticus after stroke and its risk factors.Method:The clinical data of 80 patients with post-stroke epileptic status treated from January 2018 to July 2023 were retrospectively analyzed.Analyze the recurrence of patients,age,sex,course of disease,underlying disease,body mass index(BMI),smoking history,drinking history,modified Rankin scale(mRS)score at admission,periodic epileptoid discharge,pulmonary infection,stroke type(ischemic stroke,hemorrhagic stroke),lesion site(cortical,subcortical),lesion extent(multi-lobe,single-lobe),the National Institutes of Health stroke scale(NIHSS)score at admission and other general data were collected,logistic multivariate regression analysis to analyze the risk factors for recurrent status epilepticus after stroke.Result:Among 80 patients with epileptic status after stroke,14 cases(17.50%)recurrence,and were included in the recurrence group.The other 66 cases(82.50%)did not recurrence,which was included in the non-recurrence group.There were no significant differences in age,gender,course of disease,underlying diseases,BMI,smoking history,drinking history and mRS score at admission between the two groups(P>0.05).The proportion of recurrent epileptiform discharge,pulmonary infection,hemorrhagic stroke,cortex,multiple lobes and NIHSS score in recurrent group were higher than those of non-recurrent group,the differences were statistically significant(P<0.05).logistic regression analysis showed that periodic epileptoid discharge,NIHSS score at admission,stroke type,lesion site and pulmonary infection were independent risk factors for recurrence in patients with epileptic status after stroke(P<0.05).Conclusion:Recurrent epileptic discharge,NIHSS score at admission,type of stroke,location of lesion and pulmonary infection are closely related to the recurrence of epileptic status after stroke.

关 键 词：脑卒中 癫痫持续状态 复发 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R743.3[医药卫生—临床医学]