卒中后痫性发作复发的影响因素

Related factors of post-stroke seizure recurrence

目的探讨卒中后痫性发作(PSS)复发的影响因素。方法根据是否复发将78例脑卒中后痫性发作的患者分为单次发作组和复发组,并收集患者的临床资料。结果单次发作组与复发组早发性痫性发作(ES)和迟发性痫性发作(LS)发生率差异有统计学意义(χ^(2)=4.649,P=0.031),PSS发作类型及异常EEG率差异无统计学意义(χ^(2)=3.739,P=0.154;χ^(2)=1.278,P=0.258)。单次发作组和复发组入院时NIHSS评分(t=7.820,P=0.000)及皮质受累率(χ^(2)=6.160,P=0.013)差异有统计学意义。Logistic回归分析显示,入院时NIHSS评分(OR=2.489,95%CI:1.639~3.780,P=0.000)、ES/LS发生率(OR=4.610,95%CI:0.056~20.128,P=0.042)是复发的影响因素。接受药物治疗及未接受治疗ES的患者的复发率差异无统计学意义(P=0.597),接受药物治疗及未接受治疗的LS患者的复发率差异有统计学意义(P=0.037)。结论LS患者首次痫性发作后复发率高,入院时NIHSS评分、ES/LS发生率是PSS复发的影响因素。药物治疗对预防LS患者痫性发作复发有一定作用。

Objective To analyze the related factors of post-stroke seizure(PSS)recurrence.Methods According to the seizure-numbers of the patients,78 PSS patients were divided into single seizure group and recurrent group.The clinical data were collected.Results There was significant difference in rates of early onset seizures(ES)/late onset seizures(LS)between single seizure group and recurrence group(χ^(2)=4.649,P=0.031),but there was no significant difference in seizure type and abnormal EEG rate(χ^(2)=3.739,P=0.154;χ^(2)=1.278,P=0.258).There were significant differences in NIHSS score on admission(t=7.820,P=0.000)and cortical involvement rate(χ^(2)=6.160,P=0.013)between two groups.Multivariate Logistic regression analysis showed that NIHSS score(OR=2.489,95%CI:1.639-3.780,P=0.000)and rates of ES/LS(OR=4.610,95%CI:0.056-20.128,P=0.042)were independent risk factors for PSS recurrence.There was no statistically significant difference in the recurrence rate between patients receiving drug treatment and those not receiving treatment in ES patients(P=0.597),and there was statistically significant difference in the recurrence rate between patients receiving drug treatment and those not receiving treatment in LS patients(P=0.037).Conclusions The recurrence rate is high after the first seizure in LS group.NIHSS score and the rates of ES/LS are independent risk factors for seizure recurrence after ischemic stroke.Drug therapy has a certain effect on preventing the recurrence of epilepsy in patients with LS.