局灶性癫痫发作期心率变化危险因素的临床研究

发布时间：2017-12-30 22:26

  本文关键词：局灶性癫痫发作期心率变化危险因素的临床研究　出处：《苏州大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 局灶性癫痫 发作期 心率变化 危险因素

【摘要】：目的:通过视频脑电-心电监测,研究局灶性癫痫发作期心率变化危险因素,了解心血管功能的神经调节机制,以便发病初期尽早控制癫痫发作,降低癫痫发作对心脏造成的损害。方法:我们回顾性分析苏州大学附属第一医院2013年1月~2015年12月54例术前评估的局灶性癫痫患者183次临床发作的视频脑电-心电监测资料,包括单纯部分性发作25次,复杂部分性发作44次,部分性发作继发全面强直-阵挛发作114次(除外原发性全面性发作)。我们收集视频脑电-心电监测下的局灶性癫痫患者安静状态下基础心率(每次脑电发作起始前5分钟)、发作期最大心率(瞬时的,计算最短的RR间期),计算局灶性癫痫发作期心率变化(发作期最大心率与基础心率的差值)。评估性别、年龄、意识状态、部位、侧别、发作类型、癫痫病程、部分性发作继发全面强直-阵挛发作的发作频率(partial seizures with secondary generalized tonic-clonic seizure frequency,简称sGTCS发作频率)、抗癫痫药物数量(number of anti-epileptic drugs,简称AEDs数量)、病因这些因素对局灶性癫痫发作期心率变化的影响。结果:1、本研究发现年龄、意识状态、发作类型、癫痫病程、sGTCS发作频率对局灶性癫痫发作期心率变化的影响存在统计学差异,而性别、侧别、部位、AEDs数量、病因对局灶性癫痫发作期心率变化的影响无统计学意义。2、通过Spearman相关分析得出:年龄与局灶性癫痫发作期心率变化存在正相关,即随着年龄增长,癫痫发作心率增加更明显。3、通过简单线性回归分析得出:局灶性癫痫发作期心率变化与年龄、意识状态、发作类型、sGTCS发作频率存在线性回归关系,进一步多元线性回归分析得出:年龄、发作类型、sGTCS发作频率是局灶性癫痫发作期心率变化的独立危险因素,即年龄越大、部分性发作继发全面强直-阵挛发作、sGTCS发作频率≥4次/月是癫痫发作心脏损害的高危因素。结论:1、成人、睡眠期、部分性发作继发全面强直-阵挛发作、癫痫病程5-10年、sGTCS发作频率≥4次/月会引起局灶性癫痫发作期心率变化的显著增加。2、年龄与局灶性癫痫发作期心率变化存在正相关,即随着年龄增长,癫痫发作心率增加更明显。3、年龄、发作类型、sGTCS发作频率是局灶性癫痫发作期心率变化显著增加的独立危险因素,即年龄越大、部分性发作继发全面强直-阵挛发作、sGTCS发作频率≥4次/月是癫痫发作心脏损害的高危因素。所以,发病初期尽早控制癫痫发作,避免部分性发作泛化为全面强直-阵挛发作,或许在降低癫痫发作对心脏损害方面起着一定作用。
[Abstract]:Objective: to study the risk factors of heart rate changes in focal epileptic seizures and to understand the neuroregulation mechanism of cardiovascular function in order to control seizures as early as possible. Reduce the damage to the heart caused by seizures. Methods:. From January 2013 to December 2015, we retrospectively analyzed the video EEG ECG monitoring data of 54 patients with focal epilepsy who had been assessed preoperatively in the first affiliated Hospital of Suzhou University. There were 25 simple partial seizures and 44 complex partial seizures. A total of 114 generalized tonic-clonic seizures (excluding primary generalized seizures) were secondary to partial seizures. We collected the basic heart rate (BHR) of patients with focal epilepsy monitored by video EEG and ECG. Five minutes before the onset of each EEG attack. The maximal heart rate (instantaneous, calculate the shortest RR interval), calculate the heart rate change (the difference between the maximum heart rate and the base heart rate) in the focal epileptic seizure period. Evaluate the sex, age, consciousness state. Site, side, seizure type, epilepsy process. The frequency of generalized tonic-clonic seizures secondary to partial seizures (. Partial seizures with secondary generalized tonic-clonic seizure. Frequency. The number of antiepileptic drugs is the number of anti-epileptic drugs (AEDs number). Effects of these factors on heart rate changes during focal epileptic seizures. Results: 1. This study found age, state of consciousness, seizure type, and epileptic course. There was statistical difference in the effect of frequency of sGTCS attack on the changes of heart rate in focal epileptic seizures, while the number of sex, side and location of AEDs was significantly different. The influence of etiology on the heart rate changes in focal epileptic seizures was not statistically significant. By Spearman correlation analysis, it was concluded that there was a positive correlation between age and heart rate changes in focal epileptic seizures. That is, with the increase of age, epileptic attack heart rate increased more significantly. Through simple linear regression analysis: focal epileptic seizures period heart rate changes and age, state of consciousness, attack type. There was a linear regression relationship between the frequency of sGTCS seizures, and further multiple linear regression analysis showed that age, attack type and frequency of seizure were independent risk factors of heart rate change in focal epilepsy. That is, the higher the age, the higher the frequency of generalized tonic-clonic seizure (GTCS) more than 4 times a month. Conclusion: 1, adult, sleep. Partial seizures were secondary to generalized tonic-clonic seizures, and the frequency of seizure of sGTCS 鈮，

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