| 蒋艳,康真真,杨琳,张丽萍.老年癫痫持续状态死亡相关危险因素的研究[J].浙江中西医结合杂志,2018,28(1): |
| 老年癫痫持续状态死亡相关危险因素的研究 |
| Mortality-related risk factors of status epilepticus in elder adult patient |
| 投稿时间：2017-03-05 修订日期：2017-05-07 |
| DOI： |
| 中文关键词: 老年 癫痫持续状态 死亡相关危险因素 癫痫持续状态严重程度评分 |
| 英文关键词:Elder patient Status epilepticus mortality-related risk factor Status epilepticus severity score |
| 基金项目:国家自然科学(81301113) |
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| 摘要点击次数: 546 |
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| 中文摘要: |
| 目的：评估老年癫痫持续状态(Status epilepticus, SE)患者的临床特点及预后不良的相关因素。方法：对2012年1月至2016年6月期间在浙江省中医院湖滨和下沙院区住院治疗的56例60岁以上老年癫痫持续状态患者病历资料进行回顾性评估,对存活或死亡患者进行危险因素比较,并将多个危险因素进行logistic回归分析。结果：56例患者中,死亡16例,死亡率为28.6%,存活组和死亡组患者在年龄(χ2=7.937,p=0.047)、意识状态(χ2=14.052, p=0.001)、最严重的癫痫类型(χ2=6.244,p=0.044)、治疗前SE持续时间(χ2=4.611,p=0.039)及抗癫痫药物(χ2=6.544,p=0.038)存在统计学差异。Logistic回归分析显示影响老年SE患者死亡率的危险因素为年龄(OR=3.383,95%CI为1.216-9.418)、意识状态(OR=3.942,95%CI为1.018-15.267)、抗癫痫药物级别(OR=4.656,95%CI为1.167-18.574)。死亡与存活组STESS值存在统计学差异(z=-2.477, p=0.013)。以3分为界值,计算STESS老年SE人群中的灵敏度为80.0%,特异度为68.8%。结论：年龄、意识状态、抗癫痫药物级别为影响老年癫痫持续状态患者预后的最严重危险因素,STESS在评估老年SE患者的预后方面存在一定的局限性。 |
| 英文摘要: |
| Objective: The aim of this study was to assess the clinical features and the mortality-related risk factors in Chinese in-hospital elder patients with SE. Methods: The clinical data for all elder adult patients with SE from Jan 2012 to June 2016 were derived from a prospective SE database of Zhejiang provincial hospital of traditional Chinese medicine. The outcome-related factors were analyzed and the weight of the risk factors was compared by a logistic regression analysis. Results: Among the 56 patients with SE recruited into the study, 16 (28.6%) died in the hospital. There were significant differences in age (χ2=7.937, p=0.047), the state of consciousness (χ2=14.052, p=0.001), the most serious type of epilepsy (χ2=6.244, p=0.044), the duration of SE before the treatment (χ2=4.611, p=0.039) and antiepileptic drugs (χ2=6.544, p=0.038) between the survival group and death group of patients. Logistic regression analysis showed that the risk factors for mortality in elderly patients with SE were age (OR=3.383, 95%CI 1.216-9.418), state of consciousness (OR=3.942, 95%CI 1.018-15.267)、antiepileptic drugs (OR=4.656, 95%CI 1.167-18.574). There was significant difference in STESS value between death and survival group (z=-2.477, p=0.013). The sensitivity of STESS in the elderly SE population was 80% and the specificity was 68.8% with the cutoff value for 3. Conclusions: The age, state of consciousness and antiepileptic drugs are the most important risk factors for the prognosis of elderly patients with status epilepticus. There are some limitations of STESS in evaluating the prognosis of elderly patients with SE. |
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