惊厥性癫痫持续状态的相关病因学分析

Etiological analysis of convulsive status epilepticus

目的：探讨惊厥性癫痫持续状态（CSE）的相关病因学分布规律，完善对癫痫急诊的认识，为制定CSE的预防以及控制对策提供科学依据。方法：回顾性分析87例CSE患者的临床资料，对患者性别、生活环境、发病诱因及病因等进行多因素分析。结果：男性发病率高于女性，且农村发病率高于城市；城市CSE患者中首要病因为急性脑血管病；农村患者中首要病因为中枢神经系统感染。无癫痫病史者，以急性脑血管病、中枢神经系统感染为主要的危险因素；有癫痫病史者，发病诱因中多以急性上呼吸道感染伴发热、不规范抗癫痫治疗为主。结论：脑血管病、中枢神经系统感染、停用抗癫痫药物（AED）是CSE最主要的病因；上呼吸道感染、不规范AED使用是最常见的诱因。防治脑血管病、预防感染、规律服用AED以及减少各种诱因是预防本病的关键。农村患者发病率较高，且常因地处偏远地区无法及时就诊，加强农村地区癫痫知识的普及和完善癫痫急诊的绿色通道是癫痫防治工作的重点。

Objective：To investigate the related etiological distribution of convulsive status Epilepti- cus （CSE）, so as to provide scientific basis for the control and prevention of CSE. Methods：Retrospective analysis was conducted to detect the clinical data of 87 patients with CSE from Department of Neurology of Guiyang Hospital, except excluded patients with non-convulsive status epilepticus （NCSE）. Their gender, living conditions, pathogenesis and etiology of the patients were analyzed. Results： The average age of the patients was 27. 44±5. 57, and the ratios of the male and the female were 65. 52%, and 34.48% respectively. There were 48 cases （55.17%） from rural areas and 39 cases （44. 830/oo） from ur- ban areas, showing that the former had a higher incidence of CSE than the latter. The secondary epilepsy accounted for 89.65%, 72.41% of patients with CSE onset. For the rural group, the primary cause of CSE was the infection of central nervous system （CNS）, followed by discontinuation of antiepileptic drugs （AEDs） and acute cerebrovascular disease. In the urban group, the primary cause of acute cerebro- vascular disease, followed by CNS infection and discontinuation of AEDs. Conclusion：The cerebrovascular disease, CNS infection, discontinuation of AEDs are the common causes of CSE. Rural population have a higher morbidity of CSE than urban population. Delayed treatment for the rural patients is a more dan- gerous factor than for the urban patients.