脑卒中后癫痫发生的危险因素分析

Risk factors for epilepsy after stroke

目的 探讨影响脑卒中后癫痫发生的危险因素,以期为临床相关治疗提供参考。方法 选取2019年1月—2021年12月于驻马店市中心医院神经内科就诊的脑卒中患者236例为研究对象。根据患者是否发生癫痫,分为癫痫组(n=15)和无癫痫组(n=221)。收集患者资料,包括年龄、性别、脑卒中类型、基础病史、合并症、吸烟史、饮酒史、病灶情况等。采用多因素Logistic回归分析影响脑卒中后癫痫发生的因素。结果 236例脑卒中患者中,癫痫发作15例,脑卒中后癫痫发生率为6.36%(15/236),其中早发型3例(20%),晚发型12例(80%)。经多因素Logistic回归分析得知,男性、合并肺部感染、病灶部位在大脑皮质、病灶范围为大面积脑梗死是脑卒中后癫痫发生的影响因素(P<0.05)。结论 脑卒中后存在癫痫发作风险,且以晚发型多见,而男性、合并肺部感染、病灶部位在大脑皮质、大面积脑梗死是脑卒中后癫痫发生的主要诱因,临床需加强防控,以降低癫痫发生率,改善患者预后。

Objective This paper aims to investigate the risk factors for the occurrence of epilepsy after stroke in order to provide a reference for clinical treatment.Methods A total of 236 stroke patients who visited the Neurology Department of Zhumadian Central Hospital from January 2019 to December 2021 were selected as the study participants.Patients were assigned to the epilepsy group(n=15) and no epilepsy group(n=221) according to whether they developed epilepsy.Patient data were collected,including age,gender,stroke type,underlying medical history,comorbidities,smoking history,drinking history,and lesion status.Multivariate logistic regression was used to analyze the factors for the occurrence of epilepsy after stroke.Results Among 236 stroke patients,15 cases of epileptic seizures were observed.The incidence of epilepsy after stroke was 6.36%(15/236),including 3 cases(20%) of early onset and 12 cases(80%) of late-onset.Multivariate logistic regression analysis showed that male,pulmonary infection,cerebral cortex,and massive cerebral infarction were the influencing factors of epilepsy after stroke(P<0.05).Conclusion Risk factors for epileptic seizures after stroke were observed,with late-onset being more common.Male,pulmonary infection,cerebral cortex,and massive cerebral infarction are the main predisposing factors for epilepsy after stroke.Prevention and control should be strengthened in order to reduce the incidence of epilepsy and promote the prognosis of patients.