慢性肾衰竭患者合并癫痫发作的影响因素分析

Influencing factors of epileptic seizure in patients with chronic renal failure

目的探讨慢性肾衰竭合并癫痫发作的临床影响因素。方法选择自2014年3月至2018年10月成都医学院第一附属医院肾病科收治的慢性肾衰竭患者为研究对象,并根据患者是否合并癫痫分为癫痫组(n=40)及非癫痫组(n=3653)。比较2组患者住院天数、透析情况、是否有感染、感染部位、抗生素使用情况等一般临床资料,以及血常规、谷草转氨酶、丙氨酸转氨酶等实验室指标的差异。采用Logistic回归分析确定影响慢性肾衰竭患者合并癫痫发作的独立因素。结果癫痫组患者透析时间、住院天数长于非癫痫组,感染发生率、透析比例高于非癫痫组,预后明显差于非癫痫组,差异均有统计学意义(P<0.05)。癫痫组患者白细胞数明显高于非癫痫组,血红蛋白、丙氨酸转氨酶、白蛋白含量明显低于非癫痫组,尿素氮、肌酐、血钾含量明显高于非癫痫组,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示血钾、透析、肌酐、尿素氮是慢性肾衰竭合并癫痫的独立影响因素。结论慢性肾衰竭患者合并癫痫发作的病因复杂,与透析、毒素水平、电解质紊乱有关,且患者预后较差。

Objective To investigate the influencing factors of epileptic seizure in chronic renal failure(CRF)patients.Methods CRF patients,admitted to our hospital from March 2014 to October 2018,were chosen in our study,and divided into epilepsy group(n=40)and non-epilepsy group(n=3653)according to whether the patients were with or without epilepsy.Clinical data,as length of hospital stays,dialysis methods,presences of infection,sites of infection,and use of antibiotics,and laboratory variables,as blood routine examination,straw aminotransferase(AST),and alanine aminotransferase(ALT),were collected and retrospectively analyzed.Logistic regression analysis was used to determine the independent factors affecting seizures in patients with CRF.Results The patients in the epilepsy group had significantly longer duration of dialysis and length of hospital stays,statistically higher incidence of infection and proportion of dialysis,and significantly worse prognosis than the patients from non-epilepsy group(P<0.05).The leukocyte count of the epilepsy group was significantly higher than that of the non-epilepsy group,the contents of hemoglobin,ALT and albumin were significantly lower than those of the non-epilepsy group,and the contents of urea nitrogen,creatinine and serum potassium were significantly higher than those of the non-epilepsy group(P<0.05).Logistic regression analysis showed that epilepsy was associated with serum potassium,creatinine,urea nitrogen and dialysis.Conclusion The etiology of epilepsy is complex,which is related to dialysis,toxin levels,and electrolyte imbalance;the mortality rate of those patients is high and the prognosis is not good.