摘要
目的分析全面惊厥性癫痫持续状态（generalized convulsive status epilepticus,GCSE）预后不良的相关因素，为改善预后提供指导。方法将66例GCSE患者根据疗效分为难治性癫痫持续状态（refractory statusepil epticus，RSE）和非难治性癫痫持续状态（non-refractory status epilepticus，NRSE），比较两组预后并分析预后不良的相关因素。结果RSE组的病因（急性症状性）、长时程发作、脑炎、并发低血压或呼吸抑制5项指标均高于NRSE组，病因（癫痫相关）低于NRSE组。多因素logistic回归分析提示脑炎及长时程发作是RSE的独立危险因素，校正的OR（95％C／）分别为39．37（6．577～235．671）、11．628（1．92～70．419）。多因素logistic回归分析还发现呼吸抑制为短期预后不良的独立危险因素，校正的OR（95％（2／）为16（3．713～68．955）。病因（急性症状性）与脑炎分别是远期恢复至发病前与遗留癫痫的独立影响因素，校正的OR（95％C／）分别为0．127（0．027～0．604）、7．7（1．661～35．692）。结论脑炎及长时程发作是RSE的独立危险因素；呼吸抑制与短期预后不良（死亡或昏迷）独立相关；病因（急性症状性）与脑炎分别是恢复至发病前与遗留癫痫的独立危险因素。
Objective To evaluate clinical data associated with poor outcome of generalized convul- sive status epilepticus （GCSE）. Methods Sixty-six patients with GCSE were divided into refractory status epilepticus （RSE） group and non-refractory status epilepticus （NRSE） group. Prognosis was compared between both groups and clinical data associated with poor outcome were also analyzed. Results The difference between both groups was statistically significant in etiology （acute symptomatic）, prolonged GCSE duration, etiology （encephalitis and epilepsy related） as well as concurrent hypotension and respiratory depression. By further multi- factor logistic regression, encephalitis and prolonged GCSE duration were independently associated with RSE （OR = 39. 37, 95% CI： 6. 577 235. 671; OR = 11. 628,95% CI： 1.92-70. 419） . Multi-factor logistic regression revealed concurrent respiratory depression was independently associated with poor outcome on discharge （OR = 16, 95 % CI ： 3. 713-68. 955）, while etiology（acute symptomatic） and encephalitis were independent risk factors for not returning to baseline and legacy epilepsy, respectively （OR=0. 127,95 % CI ： 0. 027-0. 604; OR = 7.7,95% CI： 1. 661-35. 692）. Conclusions Encephalitis and prolonged GCSE duration as independent risk factors for RSE are confirmed. Respiratory depression is associated with poor outcome on discharge, while etiology（acute symptomatic） and encephalitis are independent risk factors not for returning to baseline and legacy epilepsy,respectively.
出处
《神经疾病与精神卫生》
2013年第3期240-243,共4页
Journal of Neuroscience and Mental Health
基金
首都临床应用特色基金资助项目（Z111107058811010）
