脑卒中后癫痫发作的危险因素分析

Risk factors of epilepsy after stroke

目的分析脑卒中后癫痫发作的危险因素。方法选取2014年9月至2016年1月期间本院神经内科住院的脑卒中后癫痫发作患者47例和脑卒中未出现癫痫发作患者60例，分别设为研究组（n=47）和对照组（n=60），收集两组患者的相关临床资料并进行统计学分析，比较两组基本资料、既病史、脑卒中病情情况等因素与脑卒中后癫痫发作的关系，并进行Logistic多因素回归分析。结果两组年龄、饮酒史、合并心脏病、卒中类型、病灶部位、病灶范围、卒中面积、卒中体积、NHISS评分比较差异均有统计学意义（均P〈0．05）。Logistic多因素回归分析证实高龄、饮酒史、合并心脏病、卒中类型、病灶部位（皮质）、病灶范围（多脑叶）、缺血性脑卒中面积大、出血性脑卒中体积大、严重神经功能缺损为脑卒中后癫痫发作的主要危险因素。结论脑卒中后癫痫发作的危险因素包括高龄、饮酒史、合并心脏病、卒中类型、病灶部位（皮质）、病灶范围（多脑叶）、缺血性脑卒中面积大、出血性脑卒中体积大、严重神经功能缺损，可采取相关针对性措施进行预防和治疗。

Objective To analyze the risk factors of epilepsy after stroke. Methods Forty-seven patients with epilepsy after stroke and 60 patients without epilepsy after stroke who were admitted into the department of neurology at our hospital from September, 2014 to January, 2016 were selected and set as a study group （n=47） and a control group （n=60）. The clinical data of both groups were collected and statistically analyzed. The relationships between basic data, disease history, and the conditions of stroke and the incidence of epilepsy after stroke were analyzed. Multivariate logistic regression analysis was carried out. Results There were significant differences between the two groups in age, drinking history, being complicated with heart disease, stroke types, lesion location, area of lesion, area of stroke, stroke volume, and NHISS score （P〈 0.05）. Multivariate logistic regression analysis confirmed that advanced age, drinking history, being complicated with heart disease, stroke type, lesion location （cortex）, area of lesion （multiple lobes）, large area of ischemic stroke, large volume of hemorrhagic stroke, and severe neurological deficits were the main risk factors for the occurrence of epilepsy after stroke. Conclusions The risk factors for the occurrence of epilepsy after stroke include advanced age, drinking history, being complicated with heart disease, stroke type, lesion location （cortex）, area of lesion （multiple lobes）, large area of ischemic stroke, large volume of hemorrhagic stroke, and severe neurological deficits. Related measures should be adopted for prevention and treatment.