摘要
目的探讨发展为耐药性癫痫的相关危险因素。方法对2013年3月～2014年7月就诊于苏州大学附属第二医院癫痫专病门诊的230例癫痫患者进行随访观察。依据国际抗癫痫联盟耐药性癫痫定义对纳入患者治疗效果进行评估,对一种抗癫痫药物治疗失败的患者,首选提高药物剂量到50%WHO推荐日剂量以上以达到规范化治疗。对耐药性癫痫的相关因素进行Logistic回归分析,探测相关预测因子。结果多因素Logistic回归分析示MRI阳性（OR=2.214,95%CI：1.011～4.851,P=0.047）、治疗前发作次数≥10次（OR=4.856,95%CI：2.214～10.649,P〈0.0001）、治疗后EEG癫痫波样异常（OR=3.500,95%CI：1.618～7.571,P=0.001）与耐药性癫痫有显著的相关性。结论 MRI阳性、治疗前发作频率高及治疗后EEG癫痫波样异常的患者易发展为耐药性癫痫。
Objective To identify the relative risk factors of drug-resistant epilepsy. Methods A follow-up study was conducted involving 230 patients who were attended at the Epilepsy Outpatient Clinic of the Second Affiliated Hospital of Soochow University during March 2013 to July 2014. According to the International League Against Epilepsy＇s definition of drug-resistant epilepsy,outcomes of antiepileptic drugs were categorized. Higher dosage to 50% WHO defined daily dose was applied first if an antiepileptic drug（ AED） failed. Statistical analysis were carried out by multivariate logistic regression to find the risk factors of drug-resistant epilepsy. Results The statistically significant factors associated to drug-resistant that were found in our population were MRI evidence of structural cerebral abnormality（ OR = 2. 214,95% CI： 1. 011- 4. 851,P = 0. 047）,frequency of epilepsy more than10 seizures before treatment（ OR = 4. 856,95% CI： 2. 214- 10. 649,P〈0. 0001） and abnormal epilepsy-like EEG wave after treatment（ OR = 3. 500,95% CI： 1. 618- 7. 571,P = 0. 001）. Conclusion Patients who have MRI evidence of structural cerebral abnormality,have higher frequency attack before treatment and abnormal epilepsy-like EEG wave after treatment tend to develop into drug-resistant epilepsy.
出处
《临床神经病学杂志》
CAS
北大核心
2016年第3期168-171,共4页
Journal of Clinical Neurology
基金
苏州市科技发展计划(应用基础)(SYS201549)
关键词
耐药性癫痫
癫痫无发作
推荐日剂量
危险因素
drug-resistant epilepsy
seizure freedom
defined daily dose
risk factors
