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目的探讨急性脑血管病患者继发早期痫性发作的影响因素。方法选取2013年2月—2015年7月雅安职业技术学院附属医院神经内科收治的急性脑血管病患者100例,根据继发早期痫性发作情况分为继发组和无继发组,每组50例。比较两组患者临床资料,急性脑血管病患者继发早期痫性发作的影响因素分析采用多因素Logistic回归分析。结果继发组患者中男30例(占60.0%),女20例(占40.0%);年龄<50岁者30例(占60.0%);40例(占80.0%)为出血性脑血管病,其中出血部位位于皮质者30例(占75.0%),多发病灶30例(占75.0%),大面积出血30例(占75.0%),均表现为癫痫持续状态。两组患者性别、年龄、吸烟率、饮酒率、糖尿病发生率、高血压发生率及冠心病发生率比较,差异无统计学意义(P>0.05);两组患者病变性质、出血部位、病灶数量、大面积出血发生率、SSS评分<30分者所占比例及既往有脑出血史者所占比例比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,病变性质[OR=1.731,95%CI(1.004,2.986)]、出血部位[OR=2.038,95%CI(1.234,3.366)]、病灶数量[OR=1.989,95%CI(1.071,3.696)]、大面积出血[OR=2.065,95%CI(1.011,4.214)]、SSS评分[OR=2.149,95%CI(1.059,4.360)]及既往脑出血[OR=2.368,95%CI(1.056,5.301)]是急性脑血管病患者继发早期痫性发作的影响因素(P<0.05)。结论病变性质、出血部位、病灶、大面积出血、SSS评分<30分及既往有脑出血是急性脑血管病患者继发早期痫性发作的影响因素。
Objective To investigate the influencing factors of secondary seizure in patients with acute cerebrovascular disease. Methods A total of 100 patients with acute cerebrovascular disease admitted to the Department of Neurology, Affiliated Hospital of Ya’an Vocational and Technical College from February 2013 to July 2015 were divided into secondary group and non-secondary group according to secondary early seizures. 50 cases. The clinical data of two groups were compared. The influential factors of secondary early seizure in patients with acute cerebrovascular disease were analyzed by multivariate logistic regression analysis. Results There were 30 males (60.0%) and 20 females (40.0%) in the secondary group. Thirty patients (60.0%) were older than 50 years and 40 (80.0%) were hemorrhagic cerebrovascular diseases 30 cases (75.0%) were located in the cortex, 30 cases were multifocal (75.0%) and 30 cases were large-scale hemorrhage (75.0%), which all showed status epilepticus. There was no significant difference in gender, age, smoking rate, drinking rate, incidence of diabetes, incidence of hypertension and incidence of coronary heart disease between the two groups (P> 0.05). The lesions, bleeding sites, number of lesions , The incidence of massive hemorrhage, the proportion of SSS score less than 30 points and the proportion of previous history of cerebral hemorrhage, the difference was statistically significant (P <0.05). Multivariate Logistic regression analysis showed that the nature of the lesion (OR = 1.731, 95% CI 1.004, 2.986), bleeding site [OR = 2.038,95% CI 1.234,3.366] (OR = 2.065, 95% CI (1.011, 4.214)], SSS score [OR = 2.149,95% CI (1.059, 4.360)] and previous intracerebral hemorrhage [OR = 2.368, 95% CI (1.056, 5.301)] were the influencing factors of secondary eclampsia in patients with acute cerebrovascular disease (P <0.05). Conclusion The nature of the lesion, bleeding site, lesion, large area bleeding, SSS score <30 points and previous intracerebral hemorrhage are the influencing factors of secondary epileptic seizures in patients with acute cerebrovascular disease.