急性缺血性脑卒中患者早发型癫痫发作的危险因素分析

Analysis of related risk factors for early-onset epilepsy of patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(CIS)患者早发型癫痫发作的危险因素,为其临床防治提供依据。方法收集2019-09—2023-09漯河市第二人民医院治疗的CIS早发型癫痫发作患者80例为观察组,随机抽取同期住院治疗80例无癫痫发作的急性缺血性脑卒中患者为对照组,比较2组患者的一般资料(性别、年龄),基础疾病(原发性高血压、糖尿病、高脂血症、冠心病),不良嗜好(吸烟、饮酒),血清电解质、同型半胱氨酸、神经元烯醇化酶水平,梗死部位(皮质、皮质下)、梗死灶数量(单发、多发)、梗死病因(心源性、非心源性)及入院时NIHSS评分。结果2组患者在梗死部位、梗死灶数量、梗死病因,血清同型半胱氨酸、神经元烯醇化酶水平及NIHSS评分等方面比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,梗死部位为皮质(OR=7.924,P<0.001)、梗死病因为心源性(OR=11.763,P<0.001)、血清同型半胱氨酸(OR=4.980,P<0.001)和神经元烯醇化酶(OR=4.674,P<0.001)与CIS患者早发型癫痫发作有相关性。结论梗死部位为皮质、梗死病因为心源性、血清同型半胱氨酸和神经元烯醇化酶高水平是CIS患者早发型癫痫发作的危险因素。

Objective To analyze the related risk factors for early-onset epilepsy of patients with acute ischemic stroke,and provide information for clinical prevention and treatment.Methods Eighty patients with early-onset epilepsy after acute ischemic stroke who were hospitalized from September 2019 to September 2023 were selected as the observation group,and 80 acute ischemic stroke patients without epilepsy who were hospitalized at the same time were randomly selected as the control group.The general data,bad habit,basic diseases,serum electrolyte,homocysteine,neuron-specific enolase,location of infarction,the number of infarcts,the cause of infarction,and the NIHSS score at admission were compared between the two groups.Results There were statistically significant differences in infarct location,infarct number,infarct etiology,homocysteine,neuronal enolase and NIHSS scores between the two groups(P<0.05).Multivariate Logistic regression analysis showed that cerebral cortical infarction(OR=7.924,P<0.001),cardiogenic cerebral infarction(OR=11.763,P<0.001),serum homocysteine(OR=4.980,P<0.001)and neuronal enolase(OR=4.674,P<0.001)were associated with early-onset epilepsy in CIS patients.Conclusion The cerebral cortical infarction,cardiogenic cerebral infarction,high levels of serum homocysteine and neuron-specific enolase are independent risk factors for early-onset epilepsy after acute ischemic stroke.