| 摘要: |
| 目的：研究小儿癫痫停用抗癫痫药物后复发的高危因素，为小儿癫痫复发的控制提供理论依据。方法：本研究观察对象为2013年1月至2017年1月于我院诊治的176例小儿癫痫患者，均达到病情完全控制后停药，随访1年记录复发病例，将复发病例设为观察组，未复发者设为对照组，调查两组患儿性别、年龄、发病年龄等病历资料，采用单因素与logistic回归分析方法分析儿癫痫停用抗癫痫药物后复发的独立危险因素。结果：176例患者停药1年内复发60例，复发率34.09%，平均复发时间（5.54±1.21）月；单因素分析显示两组发病年龄、发病频率、停药时机、停药后脑电图（EGG）、发作类型、颅内病灶比较差异有统计学意义（P<0.05），两组性别、用药种类比较差异无统计学意义（P>0.05）；多因素logistic回归分析结果显示，发病年龄<2岁[OR=3.211，95%CI（0.876~10.546）]、停药后EGG痫性放电[OR=2.678，95%CI（0.971~9.211）]、停药前无发作时间<4年[OR=2.213，95%CI（0.654~8.321）]、局灶性发病[OR=2.034，95%CI（0.653~9.768）]、发作频率>5次/年[OR=2.446，95%CI（0.542~8.419）]是小儿癫痫停用抗癫痫药物后复发的独立危险因素。结论：小儿癫痫停用抗癫痫药物后复发较高，发病年龄<2岁、停药后EGG痫性放电、停药前无发作时间<4年、局灶性发病、发作频率>5次/年均会增加复发风险，应根据危险因素采取针对性干预措施。 |
| 关键词: 小儿 癫痫 抗癫痫药物 复发 logistic回归分析 |
| DOI：doi:10.13407/ j.cnki.jpp.1672-108X.2019.05.008 |
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| 基金项目: |
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| Factors of Recurrence of Pediatric Epilepsy after Withdrawal of Antiepileptic Drugs |
| Qu Huixia1, Zhu Caihua 2 |
| (1. Xuchang Central Hospital, Henan Xuchang 461000, China; 2. Nanyang Center Hospital, Henan Nanyang 473000, China) |
| Abstract: |
| Objective: To investigate the high risk factors of recurrence of pediatric epilepsy after withdrawal of antiepileptic drugs, so as to provide reference for the control of recurrence of epilepsy in children. Methods: A total of 176 children with pediatric epilepsy admitted into our hospital from Jan. 2013 to Jan. 2017 were extracted as the research objects. Drug withdrawal was conducted on all patients after the disease was completely controlled, and the recurrence cases were recorded after 1 year of follow-up. Patients with recurrence were set as the observation group, and those without recurrence were set as the control group. The medical records of gender, age and age of onset were analyzed. The single factor and logistic regression analysis were used to analyze the independent risk factors for recurrence of pediatric epilepsy after withdrawal of antiepileptic drugs. Results: Of the 176 patients, 60 cases had recurrence within 1 year, the recurrence rate was 34.09%, and the average recurrence time was (5.54±1.21) months. Univariate analysis showed that the age of onset, frequency of onset, time of withdrawal, EGG, type of seizure, and intracranial lesions were statistically significant between two groups (P<0.05), while gender and type of medication were not statistically significant between two groups (P>0.05). Multivariate logistic regression analysis showed that the age of onset <2 years old (OR=3.211, 95% CI: 0.876, 10.546), EGG epileptic discharge after withdrawal (OR=2.678, 95% CI: 0.971, 9.211), no seizure time before withdrawal <4 years (OR=2.213, 95% CI: 0.654, 8.321), focal morbidity (OR=2.034, 95% CI: 0.653, 9.768) and seizure frequency >5 times/year (OR=2.446, 95% CI: 0.542, 8.419) were the independent risk factors of recurrence of pediatric epilepsy after withdrawal of antiepileptic drugs. Conclusion: The recurrence of pediatric epilepsy after withdrawal of antiepileptic drugs is relatively high. The age of onset <2 years old, EGG epileptic discharge after withdrawal, no seizure time before withdrawal <4 years, focal morbidity and seizure frequency >5 times/year can increase the risk of recurrence. Targeted interventions should be taken according to the risk factors. |
| Key words: children epilepsy antiepileptic drugs recurrence logistic regression analysis |
