脑卒中后癫痫患者发生抗癫痫药物耐药的预测因素分析

Analysis of predictive factors for anti-epilepsy drug resistance in patients with post-stroke epilepsy

目的:分析脑卒中后癫痫(PSE)患者发生抗癫痫药物耐药的预测因素。方法:收集2017年1月至2021年1月郑州大学第五附属医院收治的141例PSE患者。根据国际抗癫痫联盟对于抗癫痫药物耐药的判定标准将患者分为耐药组(n=23)与非耐药组(n=118)。采用Logistic回归分析PSE患者发生抗癫痫药物耐药的影响因素,并分析筛选出的影响因素对PSE患者发生抗癫痫药物耐药的预测价值。结果:Logistic回归分析显示,脑卒中首发年龄≤50岁、出血性脑卒中、中重度脑卒中是PSE患者发生抗癫痫药物耐药的危险因素[OR(95%CI)分别为1.226(1.108~1.356)、6.866(1.197~39.390)、0.073(0.013~0.417)]。脑卒中首发年龄≤50岁、出血性脑卒中对PSE患者发生抗癫痫药物耐药的预测价值较高,敏感度和特异度分别为0.826和0.848,0.739和0.780。结论:脑卒中首发年龄≤50岁、出血性脑卒中对于PSE患者发生抗癫痫药物耐药具有良好的预测价值。

Aim:To explore the predictive factors for anti-epilepsy drug resistance in patients with post-stroke epilepsy(PSE).Methods:A total of 141 patients with PSE who were admitted from January 2017 to January 2021 were collected,and were allocated into drug resistance group(n=23)and non-drug resistance group(n=118)according to the definition of anti-epilepsy drug resistance by the International League Against Epilepsy.Logistic regression analysis was used to determine the influential factors for anti-epilepsy drug resistance and the predicting value of those factors was assessed.Results:Logistic regression analysis showed that first stroke age≤50 years,hemorrhagic stroke,and medium and severe stroke were risk factors of anti-epilepsy drug-resistance[OR(95%CI)was 1.226(1.108-1.356),6.866(1.197-39.390),0.073(0.013-0.417)].First stroke age≤50 years and hemorrhagic stroke had higher predictive value for anti-epilepsy drug resistance,the sensitivity was 0.826 and 0.739,and the specificity was 0.848 and 0.780.Conclusion:First stroke age≤50 years and hemorrhagic stroke have high predictive value for anti-epilepsy drug resistance in the patients with PSE.