病毒性脑炎后遗症期继发性癫痫影响因素分析(1)
【摘要】 目的：分析病毒性脑炎(VE)后遗症期继发性癫痫的影响因素。方法：选取本院2016年12月-2019年12月收治的65例VE患者，将后遗症期出现继发性癫痫的患者作为试验组，未发生继发性癫痫的患者作为参照组，分析VE患者后遗症期发生继发性癫痫的影响因素。结果：65例VE患者中，20例(30.77%)出现继发性癫痫，45例(69.23%)未出现继发性癫痫。两组昏迷人数、昏迷持续时间、急性期癫痫发作次数、脑电图异常程度及颅脑MRI信号异常情况比较，差异均有统计学意义(P<0.05)。昏迷、昏迷持续时间、急性期癫痫发作次数、脑电图异常程度及颅脑MRI信号异常为VE后遗症期继发性癫痫的危险因素，差异均有统计学意义(P<0.05)。结论：昏迷、昏迷持续时间、急性期癫痫发作次数、脑电图异常程度及颅脑MRI信号异常均为VE后遗症期继发性癫痫的危险因素，临床中应对高危人群引起重视，给予针对性处理。
【关键词】 病毒性脑炎 后遗症期 继发性癫癇
[Abstract] Objective： To analyze the influencing factors of secondary epilepsy in the sequelae stage of viral encephalitis (VE). Method： A total of 65 patients with VE admitted to our hospital from December 2016 to December 2019 were selected. Patients with secondary epilepsy in sequelae stage were taken as the experimental group and those without secondary epilepsy as the reference group. The influencing factors of secondary epilepsy in sequelae stage of VE patients was analyzed. Result： Among 65 VE patients， 20 cases (30.77%) had secondary epilepsy， and 45 cases (69.23%) had no secondary epilepsy. There were statistically significant differences in coma， duration of coma， number of seizures in acute phase， abnormal degree of EEG and abnormal brain MRI signal between the two groups (P<0.05). Coma， duration of coma， number of seizures in the acute phase， abnormal degree of EEG and abnormal brain MRI signal were risk factors for secondary epilepsy in the sequelae stage of VE (P<0.05). Conclusion： Coma， duration of coma， number of epileptic seizures in the acute phase， abnormal degree of EEG and abnormal brain MRI signal are risk factors for secondary epilepsy in the sequelae stage of VE. The high-risk population should be paid more attention in clinic， and targeted treatment should be given.
[Key words] Viral encephalitis Sequelae stage Secondary epilepsy
First-author’s address： Heyuan People’s Hospital， Heyuan 517000， China
doi：10.3969/j.issn.1674-4985.2020.21.028
病毒性脑炎(VE)是一种临床常见中枢神经系统疾病，具有较高的发病率，起病急骤、病情发展迅速、患者预后普遍较差，死亡率较高，主要发生于小脑、脑干、丘脑、脑叶等部位，极易引起癫痫持续状态或癫痫急性发作，VE如果治疗不及时或方法不当，极易发展成为难治性癫痫，给社会及家庭带来沉重负担[1-2]。据不完全统计，将近2.7%～27.0%的继发性癫痫的发生与中枢神经系统感染联系密切[3]。基于此，本研究选取本院2016年12月-2019年12月收治的65例VE患者作为研究对象，旨在探究VE后遗症期继发性癫痫的影响因素，现报道如下。
1 资料与方法
1.1 一般资料 选取本院2016年12月-2019年12月收治的65例VE患者。纳入标准：(1)均存在不同程度共济失调、癫痫、行为改变、人格改变、瘫痪、意识障碍等症状;(2)腋温在37.5 ℃以上;(3)脑脊液白细胞在10×106/L以上;(4)临床资料齐全、真实;(5)CT以及MRI检查均存在脑实质损害;(6)均为首次发病。排除标准：(1)本研究开展前接受过对症治疗;(2)处于哺乳期、妊娠期女;(3)合并恶性肿瘤;(4)既往存在癫痫病史;(5)合并重度贫血、营养不良;(6)合并免疫、血液、内分泌系统疾病;(7)合并消化道溃疡;(8)合并呼吸衰竭、心力衰竭;(9)既往存在精神疾病。将后遗症期出现继发性癫痫的患者作为试验组，未发生继发性癫痫的患者作为参照组。本研究已经医院伦理委员会批准。, http://www.100md.com(黄运强 何锦照 马国重 钟广宏)
【关键词】 病毒性脑炎 后遗症期 继发性癫癇
[Abstract] Objective： To analyze the influencing factors of secondary epilepsy in the sequelae stage of viral encephalitis (VE). Method： A total of 65 patients with VE admitted to our hospital from December 2016 to December 2019 were selected. Patients with secondary epilepsy in sequelae stage were taken as the experimental group and those without secondary epilepsy as the reference group. The influencing factors of secondary epilepsy in sequelae stage of VE patients was analyzed. Result： Among 65 VE patients， 20 cases (30.77%) had secondary epilepsy， and 45 cases (69.23%) had no secondary epilepsy. There were statistically significant differences in coma， duration of coma， number of seizures in acute phase， abnormal degree of EEG and abnormal brain MRI signal between the two groups (P<0.05). Coma， duration of coma， number of seizures in the acute phase， abnormal degree of EEG and abnormal brain MRI signal were risk factors for secondary epilepsy in the sequelae stage of VE (P<0.05). Conclusion： Coma， duration of coma， number of epileptic seizures in the acute phase， abnormal degree of EEG and abnormal brain MRI signal are risk factors for secondary epilepsy in the sequelae stage of VE. The high-risk population should be paid more attention in clinic， and targeted treatment should be given.
[Key words] Viral encephalitis Sequelae stage Secondary epilepsy
First-author’s address： Heyuan People’s Hospital， Heyuan 517000， China
doi：10.3969/j.issn.1674-4985.2020.21.028
病毒性脑炎(VE)是一种临床常见中枢神经系统疾病，具有较高的发病率，起病急骤、病情发展迅速、患者预后普遍较差，死亡率较高，主要发生于小脑、脑干、丘脑、脑叶等部位，极易引起癫痫持续状态或癫痫急性发作，VE如果治疗不及时或方法不当，极易发展成为难治性癫痫，给社会及家庭带来沉重负担[1-2]。据不完全统计，将近2.7%～27.0%的继发性癫痫的发生与中枢神经系统感染联系密切[3]。基于此，本研究选取本院2016年12月-2019年12月收治的65例VE患者作为研究对象，旨在探究VE后遗症期继发性癫痫的影响因素，现报道如下。
1 资料与方法
1.1 一般资料 选取本院2016年12月-2019年12月收治的65例VE患者。纳入标准：(1)均存在不同程度共济失调、癫痫、行为改变、人格改变、瘫痪、意识障碍等症状;(2)腋温在37.5 ℃以上;(3)脑脊液白细胞在10×106/L以上;(4)临床资料齐全、真实;(5)CT以及MRI检查均存在脑实质损害;(6)均为首次发病。排除标准：(1)本研究开展前接受过对症治疗;(2)处于哺乳期、妊娠期女;(3)合并恶性肿瘤;(4)既往存在癫痫病史;(5)合并重度贫血、营养不良;(6)合并免疫、血液、内分泌系统疾病;(7)合并消化道溃疡;(8)合并呼吸衰竭、心力衰竭;(9)既往存在精神疾病。将后遗症期出现继发性癫痫的患者作为试验组，未发生继发性癫痫的患者作为参照组。本研究已经医院伦理委员会批准。, http://www.100md.com(黄运强 何锦照 马国重 钟广宏)