摘要
目的:探讨癫痫患儿发展为难治性癫痫的早期预测因素.方法:选择2019年1月至2021年12月期间在医院就诊的癫痫患儿,根据纳入排除标准及分组标准,将诊断为难治性癫痫的患儿设为难治组,诊断为药物有效性癫痫组的患儿设为有效组,通过查找住院、门诊病例、电话调查的形式完成患儿的信息采集,使用SPSS 25.0软件,采用Logistic回归分析筛选出儿童难治性癫痫的独立危险因素.结果:(1)共搜集患儿127例,经过筛选后最终发展诊断为难治性癫痫的患儿26例,药物可控癫痫患儿101例,纳入的变量共25个,其中初次发病年龄、既往脑损伤史、是否早产、家族史、发作前发育情况、癫痫持续状态、治疗前发作频率>20次、共患病、颅脑MRI异常、治疗后脑电图痫样放电、心电图异常等11个因素与难治性癫痫有关;(2)经Logistic回归分析,筛选出家族史、癫痫持续状态、治疗前发作频率大于20次、颅脑MRI异常、治疗后脑电图痫样放电是儿童难治性癫痫的独立危险因素.结论:家族史、癫痫持续状态、治疗前发作频率大于20次、颅脑MRI异常、治疗后脑电图痫样放电是儿童难治性癫痫的独立危险因素,可据此初步预测儿童癫痫的医学难治性.
Abstract
Objectives:To investigate the risk factors for the development of refractory epilepsy(RE)in chil-dren with epilepsy.Methods:Children with epilepsy who were treated at Renmin Hospital of Wuhan University from January 2019 to December 2021 were selected.According to the inclusion criteria and group criteria,children diagnosed with refractory epilepsy were set as RE group,and children di-agnosed with drug-effective epilepsy were set as control group.The information collection was com-pleted by finding inpatient and outpatient cases and telephone surveys,and independent risk factors for refractory epilepsy were screened out by logistic regression analysis using SPSS 25.0 software.Re-sults:(1)A total of 127 children were collected,26 children who eventually developed RE after screening,101 children with drug-controlled epilepsy,and a total of 25 variables were included,in-cluding 11 factors related to RE,such as age of first onset,history of previous brain injury,whether preterm birth,family history,preictal development,status epilepticus,pre-treatment seizure frequen-cy>20 times,comorbidities,abnormal brain MRI,post-treatment EEG epileptiform discharge,and ECG abnormalities.(2)After logistic regression analysis,family history,status epilepticus,pre-treatment seizure frequency greater than 20 times,abnormal brain MRI,and post-treatment EEG epileptiform discharge were independent risk factors for RE in children.Conclusion:Family history,status epilepticus,frequency of seizures greater than 20 times before treatment,abnormal MRI of the brain,and post-treatment EEG-like discharge are independent risk factors for refractory epilepsy in children,which can be used to preliminarily predict the medical refractory of childhood epilepsy.
基金项目
武汉大学医学腾飞计划资助项目(TFLC2018001)
NETL
NSTL
万方数据