| 孙蓓,王雪,张广慧.前循环大动脉闭塞性脑梗死后癫痫发作特点和临床意义[J].安徽医药,2026,30(4):712-717. |
| 前循环大动脉闭塞性脑梗死后癫痫发作特点和临床意义 |
| Characteristics and clinical significance of seizure after anterior circulation large artertic occlusive cerebral infarction |
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| DOI：10.3969/j.issn.1009-6469.2026.04.015 |
| 中文关键词: 脑梗死 脑卒中后癫痫 前循环大动脉闭塞 顶叶 颞叶 溶栓治疗 美国国立卫生研究院卒中量表 危险因素 |
| 英文关键词: Brain infarction Epilepsy after stroke Anterior circulation large artery occlusion Parietal lobe Temporal lobe Thrombolytic therapy National institutes of health strokes cale Risk factors |
| 基金项目:江苏省第五期 “333工程”培养资金资助项目( BRA2020265) |
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| 中文摘要: |
| 目的评估和分析急性前循环大动脉闭塞性脑梗死后癫痫发作的特点、危险因素及临床意义。方法选择徐州医科大学附属连云港医院 2019年 1月至 2021年 12月收治的发病 48 h内经 CT血管造影( computer tomography angiography，CTA)或磁共振血管造影( magnetic resonance angiography，MRA)证实为急性前循环大动脉主干闭塞性脑梗死病人 325例为研究对象，访 2年，根据病人脑梗死后 2年内有无卒中后癫痫发作分为卒中后癫痫发作( post-stroke seizure，PSS)组和无癫痫发作的卒中随(stroke without seizure，SWS)组，比较两组病人的临床特征、梗死灶位置及癫痫发作情况，分析 PSS的预测因素。结果 PSS组心房颤动比例( 36.5%，23/63)显著高于 SWS组( 23.4%，48/205)差异有统计学意义( P=0.039)。 PSS组累及顶叶、颞叶比例高于 SWS组，差异有统计学意义( P<0.05)。 PSS组出血转化比例显著，高于 SWS组，差异有统计学意义( P=0.021)。 PSS组基线美国国立卫生研究院卒中量表( national institutes of health stroke scale，NIHSS)评分较 SWS组高，差异有统计学意义( P=0.003)。多因素 logistic回归分析显示，基线 NIHSS评分［ OR=1.10，95%CI:(1.03，1.17)，P=0.004］、梗死累及顶叶［ OR=2.48，95%CI:(1.28，4.78)P=0.007］、梗死累及颞叶［ OR=2.68，95%CI:(1.45，4.96)，P=0.002］、出血转化［ OR=2.33，95%CI:(1.10，4.94)，P=0.027］与急性环大动脉闭塞性脑梗死后 PSS发生相关。结论急性前循环大动脉闭塞性脑梗死时，严重卒中、梗死累及顶叶、颞叶及合并出血转化可能增加卒中后癫痫发作的风险。前循， |
| 英文摘要: |
| Objective To evaluate and analyze the characteristics, risk factors and clinical significance of seizure after acute anteriorcirculation aortic occlusive cerebral infarction.Methods Three hundred and twenty-five patients with acute anterior circulation aortictrunk occlusive cerebral infarction by computer tomography angiography (CTA) or magnetic resonance angiography (MRA) within 48hours from the Lianyungang Hospital Affiliated to Xuzhou Medical University from January 2019 to December 2021 were the study sub-jects, and were followed up for 2 years, and divided into post-stroke seizure (PSS) group and stroke without seizure (SWS) group accord-ing to whether the patients had post-stroke seizure within 2 years after cerebral infarction. The location of infarct lesions, the character-istics of seizure and the predictors of PSS were analyzed.Results The proportion of atrial fibrillation in the PSS group (36.5%, 23/63)was significantly higher than that in the SWS group (23.4%, 48/205), and the difference was statistically significant (P=0.039). The pro-portion of parietal lobe and temporal lobe involvement in the PSS group was higher than that in the SWS group, and the difference wasstatistically significant (P<0.05). The proportion of hemorrhagic transformation in the PSS group was significantly higher than that inthe SWS group, and the difference was statistically significant (P=0.021). The baseline national Institutes of Health Stroke Scale (NI-HSS) score in the PSS group was higher than that in the SWS group, and the difference was statistically significant (P=0.003). Multivari-ate logistic regression analysis showed that baseline NIHSS score [OR=1.10, 95%CI: (1.03, 1.17), P=0.004], infarct involvement of pari-etal lobe [OR=2.48, 95%CI: (1.28, 4.78), P=0.007], infarct involvement of temporal lobe [OR=2.68, 95%CI: (1.45, 4.96), P=0.002], hemorrhagic transformation [OR=2.33, 95%CI: (1.10, 4.94), P=0.027] were associated with the occurrence of PSS after acute anterior circulation large artertic occlusive cerebral infarction.Conclusion In acute anterior circulation large artertic occlusive cerebral infarc-tion, stroke severity, infarction involving parietal lobes and temporal lobes, and combined hemorrhagic transformation may increase the |
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