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目的探讨临床因素和再发卒中后癫痫的关系,寻找癫痫发作的危险因素方法收集2010年1月-2016年4月在华西医院神经内科住院并完成随访的105例卒中后癫痫发作患者。应用Logistic回归模型分析影响节中后癫痫再发的风险因素。结果纳入的105例卒中后伴有癫痫发作的患者中,男62例(59.0%),中位年龄72岁;卒中发病至癫痫发作的中位时间为180d。80%患者接受了抗癫痫药物(AEDs)治疗,平均随访720d,70%患者无癫痫再发作。在多因素分析当中,年龄<72岁[OR=3.03,95%CI(1.19,7.76),P=0.02],随访时遗留中重度残疾[OR=3.01,95%CI(1.1,8.18),P=0.03],和使用两种以上AEDs[OR=3.85,95%CI(1.3,11.18),P=0.01]是卒中后癫痫再发的独立风险因素。结论针对卒中后癫痫的治疗,临床医生不仅需要积极治疗和预防原发疾病来减轻卒中后遗症,还需要根据癫痫发作类型合理正确选择AEDs来共同预防癫痫复发。
Objective To investigate the relationship between clinical factors and post-stroke epilepsy and find out the risk factors of seizures Methods A total of 105 patients with post-stroke seizures hospitalized and followed up in the Department of Neurology, West China Hospital from January 2010 to April 2016 were collected. Logistic regression model was used to analyze the risk factors affecting the recurrence of epilepsy after mid-section. Results Among the 105 patients with seizures after stroke, 62 patients (59.0%) had a median age of 72 years. The median time from onset of stroke to seizure was 180 days. Seventy percent of the patients were treated with antiepileptic drugs (AEDs), with an average follow-up of 720 days and 70% of patients without seizures. In the multivariate analysis, age <72 years (OR = 3.03, 95% CI 1.19, 7.76, P = 0.02), moderate to severe disability at follow-up [OR = 3.01, 95% CI = 0.03] and the use of more than two AEDs [OR = 3.85,95% CI (1.3,11.18), P = 0.01] was an independent risk factor for recurrent seizure after stroke. Conclusion For the treatment of post-stroke epilepsy, clinicians need not only active treatment and prevention of primary diseases to reduce the sequelae of stroke, but also need to select AEDs reasonably and correctly according to the type of seizure to jointly prevent the recurrence of epilepsy.