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目的分析影响额叶癫预后的危险因素,以便早期预测难治性额叶癫,为临床早期合理治疗提供理论依据。方法采用病例对照研究(包括药物难治组47例和药物控制良好组92例),回顾性分析两组患者的临床资料,并对各种影响因素与预后的关系进行单因素和多因素分析,多因素分析采用Logistic逐步回归,前向逐步法。结果单因素分析表明首次发病年龄早、合理药物治疗前病程长、发作频繁(>1次/d)、姿势性发作、过度运动发作、继发全身强直-阵挛发作和既往有服药史7个因素对额叶癫的预后有不利影响(均P<0.05),Logistic逐步回归分析筛选出合理治疗前病程(OR=1.384,95%CI:1.133～1.689)和发作频率(OR=6.512,95%CI:1.637～25.911)是影响额叶癫预后的独立危险因素。结论合理药物治疗前病程长和发作频繁(>1次/d)是药物难治性额叶癫的重要危险因素,因此早期正确诊断和合理治疗有可能改善额叶癫的预后。
Objective To analyze the risk factors affecting the prognosis of frontal lobe epilepsy in order to predict the refractory frontal lobe epilepsy in the early stage and provide a theoretical basis for rational early treatment. Methods A case-control study (including 47 refractory patients and 92 well-controlled patients) was conducted. The clinical data of two groups were retrospectively analyzed. Univariate and multivariate analyzes were performed on the relationship between various factors and prognosis. Multivariate analysis using Logistic regression, forward step by step. Results Univariate analysis showed that there were 7 patients with early onset of disease, long course of disease before treatment, frequent attacks (> 1 time per day), postural seizures, excessive exercise seizures, secondary tonic-clonic seizures and previous medication history The factors influencing the prognosis of frontal lobe epilepsy were both negative (P 0. 05). Logistic regression analysis screened the reasonable duration of pretreatment (OR = 1.384, 95% CI: 1.133-1.689) and the frequency of seizure (OR = 6.512, 95 % CI: 1.637 ~ 25.911) is an independent risk factor affecting the prognosis of frontal lobe epilepsy. Conclusions Long course of disease and frequent seizures (> 1 time per day) before rational drug treatment are important risk factors for drug-refractory frontal lobe epilepsy. Therefore, proper early diagnosis and reasonable treatment may improve the prognosis of frontal lobe epilepsy.