宁夏农村惊厥性癫痫患者死因分析

Analysis of the causes of death in patients with convulsive epilepsy in rural areas of Ningxia

目的分析宁夏农村惊厥性癫痫(CE)患者的死亡原因,为早期识别高危患者、制定可行的防范措施提供依据,以降低癫痫患者的死亡风险。方法通过宁夏癫痫防治管理项目办,收集2012年1月1日~2016年1月1日宁夏农村CE患者的死亡资料,采用统一的癫痫患者死亡调查问卷对死亡信息进行调查核对,回顾性分析死亡原因。结果 4年中宁夏农村CE患者共死亡187例,死亡率约为5.2/10万。死因顺位前5位依次为损伤与中毒(25.7%)、癫痫持续状态(SE,21.4%)、癫痫猝死(SUDEP,17.1%)、脑血管病(12.8%)及心脏病(7.5%)。男、女CE患者的死因构成不同(P<0.05)。其他疾病组(包括脑血管病、心脏病、恶性肿瘤、呼吸系统疾病、精神障碍、泌尿及生殖系统疾病及消化系统疾病)死亡年龄大于损伤与中毒、SUDEP以及SE组(LSD-t=5.20,P=0.000;LSD-t=4.22,P=0.000;LSD-t=6.07,P=0.000)。不同死因CE患者的死亡年龄构成不同(P<0.05)、死亡地点分布不同(P<0.05)。结论宁夏农村CE患者的首位死因是损伤与中毒,其次为SE和SUDEP。

Objective To analyze the causes of death in patients with convulsive epilepsy（CE）in rural area of Ningxia,in order to provide foundation for early identification of high-risk patients and formulation of feasible precautionary measures,thus reduce mortality of patients with CE.Methods Death data of patients with CE in rural area of Ningxia from January 1st,2012 to January 1st,2016 were collected from Ningxia Epilepsy Prevention and Management Project Office,and the uniform death questionnaire for patients with CE was adopted to investigate the death information.Results Altogether 187 patients with CE died in rural area of Ningxia in four years,with a mortality of about 5.2/100000.The top five causes of death were injury and poisoning（25.7%）,status epilepticus（SE,21.4%）,sudden unexpected deathin epilepsy（SUDEP,17.1%）,cerebrovascular disease（12.8%）and heart disease（7.5%）in succession.The constitution of cause of death weve different between male and female（P〈0.05）.Age at death in patients died of other diseases（including cerebrovascular disease,heart disease,malignancy,respiratory system disease,mental disorder,urinary and reproductive system disorders,and digestive system disease）was greater than that of injury and poisoning,SUDEP,and SE（LSD-t=5.20,P=0.000;LSD-t=4.22,P=0.000;LSD-t=6.07,P=0.000）.The constitution of age at death（P〈0.05）,as well as distribution of death place（P〈0.05）were different among patients with CE dying from various causes.Conclusions The top cause of death in patients with CE in rural area of Ningxia is injury and poisoning,followed by SE and SUDEP.