脑动静脉畸形患者癫发作的相关因素分析

Analysis of correlative factors of cerebral arteriovenous malformation with seizures

目的探讨脑动静脉畸形并发癫发作的相关危险因素以及癫的合理预防措施。方法回顾性分析286例脑动静脉畸形患者的临床及脑动静脉畸形基线资料。根据是否合并癫发作分为癫组和对照组。分析脑动静脉畸形患者并发癫发作的危险因素,观察癫组92例患者的发作类型及发作频率以及药物治疗反应情况。结果癫组与对照组畸形血管团的位置、畸形血管团直径、静脉引流方向等因素比较差异明显(P<0.05);非条件多因素Logistic回归分析显示对脑动静脉畸形患者癫发作有显著影响的因素为畸形团直径大于3 cm和由浅静脉或者浅深静脉共同引流(P<0.05)。经过抗癫药物治疗,癫组有69例患者癫发作得到了完全控制,余患者发作频率均有不同程度减低。结论畸形团直径大于3cm和由浅静脉或者浅深静脉共同引流是脑动静脉畸形患者并发癫的危险因素;脑动静脉畸形合并的癫发作是一个相对良性过程,抗癫药物对多数癫患者治疗有效。

Objective To analyze the relevantly risk factor of cerebral arteriovenous malformation with seizures and prevention measures for epilepsy. Methods The clinical data of 286 patients with cerebral arteriovenous malformations and the baseline data of the cerebral arteriovenous malformations were retrospectively analyzed. According to the occurrence of seizure,the patients were divided into epilepsy group and the control group. Analysis by comparing the differences between the two groups of cerebral arteriovenous malformation patients complicated with epilepsy risk factors. To observe 92 patients of epilepsy group attack types and attack frequency and the effect of drug treatment. Results Comparison difference of epilepsy group and control group in the location of the deformity arteriolar,deformity arteriolar diameter and venous drainage direction was statistically significant by univariate analysis（ P〈0. 05）. Unconditioned multiariable Logistic regression analysis showed that epileptic seizures in patients with cerebral arteriovenous malformations have significantly influence factors for group over 3 cm in diameter and jointly by superficial vein or shallow deep venous drainage. After antiepileptic drug treatment,epilepsy group has 69 patients clinical seizures in complete control. The rest of the patients with seizure frequency are reduced to varying degrees. Conclusions Deformity group over 3 cm in diameter and jointly by superficial vein or shallow deep venous drainage are the risk factor for cerebral arteriovenous malformation patients complicated with epilepsy; Cerebral arteriovenous malformation combined seizures are a relatively benign clinical course. For most patients with epilepsy,antiepileptic drug treatment is effective. Further studies with larger cohorts will be needed to address the effects on seizures.