摘要
目的探讨药物治疗后无发作期≥3年的成人局灶性癫痫患者撤药后癫痫复发危险因素。方法回顾性收集并分析2018年1月—2024年10月于北京天坛医院门诊就诊的成人局灶性癫痫患者的病例资料,采用χ^(2)检验(或Fisher检验)及logistic回归分析探索影响撤药后复发的危险因素。结果≥3年无发作减药的局灶性癫痫患者共109例,其中减药后复发患者73例、减药后无复发患者36例,复发率为66.97%。单因素分析结果显示:性别、起病年龄、有无合并症、用药种类与撤药后复发无相关性(P>0.05);无发作时间较短、颅内病灶是影响成人局灶性癫痫患者撤药后复发的危险因素(P<0.05)。多因素logistic回归分析结果显示,无发作时间少于4年、颅内病灶是影响成人局灶性癫痫患者撤药后复发的危险因素(P<0.05)。结论无发作时间较短、颅内病灶是影响无发作期≥3年的成人局灶性癫痫撤药后复发的危险因素。
Objective To evaluate the risk factors for seizure recurrence after withdrawal in adult patients with focal epilepsy who have been seizure-free for more than 3 years following drug treatment.Methods This study retrospectively included cases of adult patients with focal epilepsy treated with antiepileptic drugs at the outpatient department of Beijing Tiantan Hospital between January 2018 and October 2024.The chi-square test(or Fisher’s exact test)and logistic regression analysis were used to explore risk factors for seizure recurrence after withdrawal.Results This study analyzed 397 patients with focal epilepsy who maintained seizure-free for more than 3 years with complete clinical data.Among them,286 patients maintained seizure-free without medication reduction,2 patients did not reduce medication but experienced recurrence,73 patients experienced recurrence after medication reduction,and 36 patients remained seizure-free after medication reduction.Among 109 patients with focal epilepsy who withdrew medication after more than 3 years of seizure freedom,73(66.97%)experienced recurrence.Univariate analysis revealed no significant correlation between gender,age at onset,comorbidities,or number of antiepileptic drugs and post-withdrawal recurrence(all P>0.05).Shorter seizure-free duration and abnormal brain MRI findings were identified as risk factors for recurrence after withdrawal(P<0.05).Multivariate logistic regression analysis confirmed that seizure-free duration<4 years and abnormal intracranial lesion were independent risk factors for post-withdrawal recurrence(P<0.05).Conclusions Shorter seizure-free duration and abnormal intracranial lesion are risk factors for seizure recurrence after withdrawal in adult patients with focal epilepsy who have been seizure-free for≥3 years.
作者
张佳盈
左静雯
秦学银
代莹悦
邵晓秋
王群
吕瑞娟
ZHANG Jiaying#;ZUO Jingwen#;QIN Xueyin;DAI Yingyue;SHAO Xiaoqiu;WANG Qun;LV Ruijuan(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Epilepsy Unit,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《癫痫杂志》
2025年第6期477-481,共5页
Journal of Epilepsy
基金
CAAE-青峰癫痫患者管理基金(CA-Q-2021-01)
国家重点研发计划项目(2022YFC2503800)
国家重点研发计划项目(2024YFB4709900)
北京市自然科学基金(L222033)。
