国际抗癫癎联盟国际癫癎综合征分类可分类率比较及架构分析

A comparison of the classification rate and structural analysis in three International League Against Epilepsy classifications of epilepsy syndromes

目的比较国际抗癫癎联盟（International League Against Epilepsy，ILAE）1989、2001、2006年癫癎综合征分类的可分类率并分析架构变化。方法先后依据3个分类对2007年8月1日至2008年3月31日连续就诊于北京协和医院癫疴中心的1356例癫痈患者进行癫疴综合征诊断，并进行统计学分析。结果3个分类的可分类率分别为75．5％、89．O％和88．1％，2001及2006年分类明显优于1989年分类（χ^2=116．3，P〈0．01）；对特异综合征的可分类率分别为11．6％（157例）、12．0％（162例）及11．9％（160例），差异无统计学意义（χ^2=0．09，P〉0．05）。结论ILAE2006年癫癎综合征分类引入了较科学的分类模式和评价体系，提高了癫癎的可分类率，可尝试应用于临床及基础研究。

Objective To compare the classification rate of three classifications of epilepsy syndromes proposed by International League Against Epilepsy （ILAE）, and analyze their stuctural changes. Methods All patients with epilepsy who consecutively visited the epilepsy center of Peking Union Medical College Hospital between Aug. 1st, 2007 and Mar. 31 st,2008 were included. Three classifications of epilepsy syndromes were used in order. Results In this study, we could categorize 75. 5% of 1356 patients by applying the 1989 international classification of epilepsy syndromes, 89. 0% of them by the 2001 proposed diagnostic scheme and 88. 1% of them by the 2006 report. In this aspect, the 2001 and 2006 classifications were better than the 1989 classification（χ^2 = 116. 3, P 〈 0. 01 ） . However, only 11.6% （157）, 12.0% （162） and 11.9% （160）of patients with specific epilepsy syndromes were identified from the 1356 epileptic patients by three classifications, respectively. This data based on the 2001 and 2006 classifications did not change markedly in comparison with the 1989 classification （χ^2= O. 09, P 〉 0. 05 ）.Conclusions The 2006 report involve more scientific mode of classification and systematic evaluation, and can classify more patients with epilepsy. It can be used in clinical and scientific research, which can not only accumulate data for developing more scientific classification but also stimulate research especially in the fields of genetics and functional morphology.