脑静脉窦血栓形成早发性痫性发作影响因素研究

doi:10.3969/j.issn.1673-5765.2017.03.004

摘要/Abstract

摘要：

目的探讨脑静脉窦血栓形成（cerebral venous s inus thrombosis，CVST）患者早发性痫性发作的相关因素。方法选取CVST患者为研究对象，按照发病2周内有无痫性发作分为早发性痫性发作组和对照组进行回顾性分析，收集患者急性期临床表现、影像学、脑电图等临床资料，对可能影响CVST早发性痫性发作的因素进行单因素和多因素分析。结果研究纳入CVST患者64例，其中早发性痫性发作组19例（29.7%），对照组45例（70.3%）。单因素分析显示早发性痫性发作组妊娠期或产褥期（52.6% vs 20.5%，P =0.01）、意识障碍（31.6% vs 8.89%，P =0.02）、多脑叶病变（52.6% vs 24.4%，P =0.03）、静脉性脑梗死合并出血（52.6% vs 11.1%，P =0.01）、脑电图异常（73.7% vs 46.6%，P =0.01）率均显著高于对照组。Logi sti c回归分析显示多脑叶病变[比值比（odds ratio，OR）12.89，95%可信区间（confidence interval，CI）2.12～78.41）]、静脉性脑梗死合并出血（OR 12.92，95%CI 1.68～99.25）、脑电图异常（OR 2.19，95%CI 1.07～4.49）是 CVST早发性痫性发作的独立危险因素。结论多脑叶病变、静脉性脑梗死合并出血、脑电图异常是CVST早发性痫性发作的独立危险因素。

文章导读： 本文通过对脑静脉窦血栓形成患者的病例资料进行回顾性多因素分析，结果显示多脑叶病变、静脉性脑梗死合并出血、发作间期脑电图异常提示患者早发性痫性发作危险性高。

关键词: 脑静脉窦血栓形成; 癫痫; 痫性发作

Abstract:

Objective To study the correlative factors of the cerebral venous sinus thrombosis (CVST) in early-onset seizures. Methods The patients with cerebral venous sinus thrombosis were selected as subjects and were divided into early onset epilepsy group and the control group according to the criteria of whether there were epileptic seizures within 2 weeks after the onset. Retrospective analysis of patients was made upon clinical data including acute clinical manifestation, imaging and electroencephalogram (EEG), etc. Single factor analysis and binary logistic regression analysis were made to study the factors that might influence the early onset of epilepsy of CVST. Results A total of 64 patients with CVST were enrolled, among whom, there were 19 cases in early onset epilepsy group (29.7%) and 45 cases in the control group (70.3%). By the single factor analysis of early-onset epilepsy group, the puerperal women during pregnancy (52.6% vs 20.5%, P =0.01), disturbance of consciousness (31.6% vs 8.89%, P =0.02), the multiple lobes lesion (52.6% vs 24.4%, P =0.03), cerebral infarction merger of vein bleeding (52.6% vs 11.1%, P =0.01), abnormal EEG (73.7% vs 46.6%, P =0.01) were significantly higher than that of control group, with significant difference statistically. Binary logistic regression analysis showed that more cerebral lobe lesions

[(odds ratio (OR) 12.89, 95% confidence interval (CI) 2.12-78.41], cerebral infarction merger of vein bleeding (OR 12.92, 95%CI 12.92-99.25), EEG anomalies (OR 2.19, 95%CI 2.19-4.49) were risk factors for early onset seizures in CVST. Conclusion Multiple cerebral lobe lesions, vein cerebral infarction with bleeding and abnormal electroencephalogram (EEG) were independent risk factors for CVST early-onset seizures.

Key words: Cerebral venous sinus thrombosis; Epilepsy; Early-onset seizures

闫斌，朱明振，刘远洪，聂志余. 脑静脉窦血栓形成早发性痫性发作影响因素研究[J]. 中国卒中杂志, 2017, 12(03): 214-218.

YAN bin, ZHU Ming-Zhen, LIU Yuan-Hong, et al.. Study on the Influential Factors of the Cerebral Venous Sinus Thrombosis in Early-onset Seizures[J]. Chinese Journal of Stroke, 2017, 12(03): 214-218.

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