单药治疗癫痫患者停药后复发的高危因素分析

Analysis of the risk factors of epilepsy recurrence after stopping drug in patients treated with monotherapy

目的:分析经单药治疗后病情完全控制并停药的癫痫患者1年内病情复发情况,并对诱导复发的高危因素进行分析。方法:选取130例癫痫患者作为研究对象,均为经单药治疗后病情完全控制,停药后对患者进行1年以上的随访,记录癫痫复发情况,并分析引起癫痫复发的危险因素。结果:130例癫痫患者经单药治疗病情完全控制并停药后1年内复发率为40.00%(52/130);单因素分析结果显示,治疗前癫痫每年发作>5次、初始治疗前病程>1年、病程中存在癫痫持续状态、颅内有病灶、停药前有痫性放电、减停药前无发作时间<4年、减药时间<6个月的癫痫患者在停药后癫痫复发率高(P<0.05~P<0.01);多因素非条件logistic回归分析结果显示,治疗前癫痫每年发作>5次、初始治疗前病程>1年、颅内有病灶、停药前有痫性放电、减停药前无发作时间<4年、减药时间<6个月是造成停药后癫痫复发的高危因素(OR=2.976~8.742,P<0.05)。结论:单药治疗癫痫停药复发的危险因素较多,针对高危因素采取针对性干预措施有助于减少复发。

Objective ：To analyze the epilepsy recurrence within 1 year after stopping drug in complete control patients treated with monotherapy, and high risk factors of inducing relapse. Methods：The drug was stopped in 130 epilepsy patients with monotherapy after the disease was completely controlled. The patients were followed up at least 1 year after stopping drug, and the epilepsy recurrence was recorded. Results ：The recurrence rate within l year after stopping drug was 40.00% （52/130） in 130 epilepsy patients treated with monotherapy. The univariate analysis showed that the epileptic seizure was more than 5 times 1 year, the duration was more than 1 year before treatment, and the status epilepticus and intracranial lesions during the disease, epileptic discharge before stopping drug, no-attack time less than 4 years before reducing and stopping drug, high epilepsy relapse rate after stopping drug in patients with reducing drug time less than 6 months were found （ P 〈 0.05 to P 〈 0.01 ）. Multivariate logistic regression analysis showed that the epileptic seizure more than 5 times 1 year, duration more than 1 year before treatment, intracranial lesions, epileptic discharge before stopping drug, no-attack time less than 4 years before stopping and reducing drug time less, and reducing drug time less than 6 months were the high risk factors of epilepsy relapse（ OR = 2. 976 to 8. 742 ,P 〈 0.05 ）. Conclusions ：The risk factors of the epilepsy recurrence in patients treated with monotherapy after stopping drug are more ,taking appropriate intervention measures can reduce the recurrence of epilepsy.