脑胶质瘤患者首发症状为癫痫发作的危险因素分析  

Risk factors for the initial symptom of epileptic seizures in patients with glioma

作　　者：李兴超 王友芳 李明[1] 周良健 李明柱 肖帅 车峰远[3] 张金岭[4,5] LI Xingchao;WANG Youfang;LI Ming;ZHOU Liangjian;LI Mingzhu;XIAO Shuai;CHE Fengyuan;ZHANG Jinling(Office of Academic Research,Linyi People’s Hospital,Linyi 276002,China)

机构地区：[1]临沂市人民医院科研管理部,山东临沂276002 [2]临沂市人民医院重症医学科 [3]临沂市人民医院神经内科 [4]临沂市人民医院肿瘤科 [5]临沂市脑胶质瘤功能影像工程技术研究中心

出　　处：《精准医学杂志》2025年第2期170-172,177,共4页Journal of Precision Medicine

基　　金：山东省医药卫生科技发展计划项目(202303010-555);临沂市重点研发计划项目(2023YX0040)。

摘　　要：目的探讨以首发症状为癫痫的脑胶质瘤患者发病的危险因素。方法选择2016年1月-2019年12月于我院诊治的脑胶质瘤患者309例,根据首发症状是否为癫痫分为观察组(81例)和对照组(228例),收集患者一般资料(年龄、性别、吸烟史、饮酒史、慢性病史、头部外伤史、肿瘤病灶范围、肿瘤分化程度)和血液生化检验指标(血清总胆固醇、三酰甘油、高/低密度脂蛋白胆固醇及空腹血糖、钙、钾、磷)进行回顾性分析,采用多因素logistic回归分析脑胶质瘤患者癫痫发作的危险因素。结果脑胶质瘤患者首发症状为癫痫的占比为18.95%。分析结果显示,两组患者是否有饮酒史、癫痫史、糖尿病史、头部外伤史,肿瘤病灶范围、肿瘤分化程度,血清中总胆固醇、血清中低密度脂蛋白胆固醇及空腹血糖、钾、磷水平高低者的比例差异具有显著性(χ^(2)=3.915~12.513,P<0.05)。多因素logistic回归分析结果显示,有饮酒史、有癫痫史、有头部外伤史、空腹血糖高、肿瘤病灶范围大、肿瘤分化程度低是患者癫痫发作的危险因素(OR=1.257~3.823,P<0.05)。结论有饮酒史、有癫痫史、有头部外伤史、空腹血糖高、肿瘤病灶范围大、肿瘤分化程度低是脑胶质瘤患者首发症状为癫痫发作的危险因素,在临床诊治过程中对于伴有上述情况的患者应注意防范,并根据医嘱积极进行防治。Objective To investigate the risk factors for the onset of glioma in patients with the initial symptom of epilepsy.Methods A total of 309 patients with glioma who were diagnosed and treated in our hospital from January 2016 to December 2019 were enrolled,and according to whether the initial symptom was epilepsy,they were divided into observation group with 81 patients and control group with 228 patients.A retrospective analysis was performed for general information(age,sex,smoking history,drinking history,history of chronic diseases and head trauma,extent of tumor lesion,and degree of tumor diffe-rentiation)and blood biochemical parameters(total cholesterol,triglycerides,high-density/low-density lipoprotein cholesterol,fasting blood glucose,calcium,potassium,and phosphorus),and a multivariate logistic regression analysis was used to investigate the risk factors for epileptic seizures in patients with glioma.Results Among the patients with glioma,the patients with epileptic seizures as the initial symptom accounted for 18.95%.The analysis showed that there were significant differences between the two groups in the history of drinking,epilepsy,diabetes,and head trauma,the extent of tumor lesion,the degree of tumor diffe-rentiation,and the serum levels of total cholesterol,low-density lipoprotein cholesterol,fasting blood glucose,potassium,and phosphorus(χ^(2)=3.915-12.513,P<0.05).The multivariate logistic regression analysis showed that the history of drinking/epilepsy/head trauma,high fasting blood glucose,a large extent of tumor lesion,and a low degree of tumor differentiation were risk factors for epileptic seizures(OR=1.257-3.823,P<0.05).Conclusion The history of drinking/epilepsy/head trauma,high fasting blood glucose,a large extent of tumor lesion,and a low degree of tumor differentiation are risk factors for the initial symptom of epileptic seizures in patients with glioma.Patients with such conditions should be taken seriously during clinical diagnosis and treatment,and active prevention and treatment shou

关 键 词：神经胶质瘤 脑肿瘤 癫痫 危险因素 回顾性研究 

分 类 号：R730.264[医药卫生—肿瘤] R739.41[医药卫生—临床医学]