癫痫发作诱发因素的初步调查
|
摘要
目的探讨癫痫发作与诱发因素之间的关系,尽可能避免诱发因素、减少癫痫发作,以提高患者的生活质量。方法收集2018年1月—2019年1月就诊于空军军医大学西京医院癫痫专科门诊确诊为癫痫的604例患者临床资料,随访近6个月内癫痫发作的情况,应用χ~2检验分析癫痫发作与诱发因素、诱发因素之间的关系。结果在604例患者中近6个月内癫痫无发作318例(52.6%),有发作286例(47.4%),169例(59.1%)癫痫发作患者至少有一种诱发因素。常见的诱发因素:睡眠紊乱123例(72.8%),情绪变化114例(67.5%),服药不规律87例(51.5%),饮食相关97例(57.4%),月经与妊娠33例(19.5%)等。通过χ~2检验发现癫痫发作与年龄、性别差异无统计学意义(P>0.05),但Pearson相关性分析发现不同的发作形式与诱发因素之间有统计学差异,如在全面性发作中,强直阵挛发作与睡眠不足有关(χ~2=0.189),失神发作与愤怒(χ~2=0.237)、压力大(χ~2=0.203)、生活不规律(χ~2=0.214)有关;在局灶性发作中,局灶运动发作与饮用咖啡因有关(χ~2=0.145),局灶感觉发作与受凉(χ~2=0.235)、电子产品使用(χ~2=0.153)、饱腹(χ~2=0.257)有关;复杂部分发作与愤怒(χ~2=0.229)、应激(χ~2=0.187)、受凉(χ~2=0.198)有关;继发全面发作与漏服药物(χ~2=0.231)、睡眠不足(χ~2=0.158)、应激(χ~2=0.161)、受凉(χ~2=0.263)、饱腹(χ~2=0.182)有关。在诱发因素中,睡眠不足与愤怒(χ~2=0.167)、劳累(χ~2=0.283)、压力大(χ~2=0.230)有关。结论癫痫发作通常是由多种因素诱发的,全面性发作与睡眠紊乱、情绪变化、压力大、生活不规律等相关,局灶性发作与应激、情绪变化、睡眠紊乱、受凉、饱腹等相关。诱发因素相关性分析发现睡眠不足与愤怒、劳累、压力大有关。因此,明确癫痫发作的诱发因素,尽可能避免诱发因素、减少发作带来的危害,有助于提高患者的生活质量。
Objective To explore and clarify the relationship between epileptic seizure and inducing factors.Avoid inducing factors and reduce epileptic seizure,so as to improve the quality of life in patients with epilepsy.Methods Clinical data of 604 patients diagnosed with epilepsy in Xijing Hospital of Air Force Military Medical University from January 2018 to January 2019 were collected.The clinical data of patients with epilepsy were followed up6 months.Results Among the 604 patients,318(52.6%)were seizure-free in the last 6 months,286(47.4%)had seizures.169(59.1%)had seizures with at least one inducing factor.Common inducing factors:123 cases of sleep disorder(72.8%),114 cases of emotion changes(67.5%),87 cases of irregular medication(51.5%),97 cases of diet related(57.4%),33 cases of menstruation and pregnancy(19.5%),etc.Using the χ~2 test,seizures with age,gender differences had no statistical significance(P>0.05),but seizure type was statistically different between inducing factors.In generalized seizures,tonicclonic seizures associated with sleep deprivation(χ~2=0.189),absence seizures and anger(χ~2=0.23 7),pressure(χ~2=0.203),irregular life(χ~2=0.214).In the focal seizures,focal motor seizures was correlated with coffee consumption(χ~2=0.145),focal sensory seizures with cold(χ~2=0.235),electronic equipment use(χ~2=0.153),satiety(χ~2=0.257).Complex partial seizures was correlated with anger(χ~2=0.229),stress(χ~2=0.187),and cold(χ~2=0.198).The secondarily generalized seizures was correlated with drug missing(χ~2=0.231),sleep deprivation(χ~2=0.158),stress(χ~2=0.161),cold(χ~2=0.263),satiety(χ~2=0.182).Among the inducing factors,sleep deprivation was correlated with anger(χ~2=0.167),fatigue(χ~2=0.283),and stress(χ~2=0.230).Conclusions Epileptic seizure were usually induced by a variety of factors.Generalized seizures were associated with sleep disorders,emotional changes,stress,irregular life,etc.While focal seizures were associated with stress,emotional changes,sleep disorders,cold,satiety,etc.An analysis of the triggers found that sleep deprivation was associated with anger,fatigue,and stress.Therefore,to clarify the inducing factors of epileptic seizure,avoid the inducing factors as much as possible,reduce the harm caused by seizures,and improve the quality of life of patients.
Objective To explore and clarify the relationship between epileptic seizure and inducing factors.Avoid inducing factors and reduce epileptic seizure,so as to improve the quality of life in patients with epilepsy.Methods Clinical data of 604 patients diagnosed with epilepsy in Xijing Hospital of Air Force Military Medical University from January 2018 to January 2019 were collected.The clinical data of patients with epilepsy were followed up6 months.Results Among the 604 patients,318(52.6%)were seizure-free in the last 6 months,286(47.4%)had seizures.169(59.1%)had seizures with at least one inducing factor.Common inducing factors:123 cases of sleep disorder(72.8%),114 cases of emotion changes(67.5%),87 cases of irregular medication(51.5%),97 cases of diet related(57.4%),33 cases of menstruation and pregnancy(19.5%),etc.Using the χ~2 test,seizures with age,gender differences had no statistical significance(P>0.05),but seizure type was statistically different between inducing factors.In generalized seizures,tonicclonic seizures associated with sleep deprivation(χ~2=0.189),absence seizures and anger(χ~2=0.23 7),pressure(χ~2=0.203),irregular life(χ~2=0.214).In the focal seizures,focal motor seizures was correlated with coffee consumption(χ~2=0.145),focal sensory seizures with cold(χ~2=0.235),electronic equipment use(χ~2=0.153),satiety(χ~2=0.257).Complex partial seizures was correlated with anger(χ~2=0.229),stress(χ~2=0.187),and cold(χ~2=0.198).The secondarily generalized seizures was correlated with drug missing(χ~2=0.231),sleep deprivation(χ~2=0.158),stress(χ~2=0.161),cold(χ~2=0.263),satiety(χ~2=0.182).Among the inducing factors,sleep deprivation was correlated with anger(χ~2=0.167),fatigue(χ~2=0.283),and stress(χ~2=0.230).Conclusions Epileptic seizure were usually induced by a variety of factors.Generalized seizures were associated with sleep disorders,emotional changes,stress,irregular life,etc.While focal seizures were associated with stress,emotional changes,sleep disorders,cold,satiety,etc.An analysis of the triggers found that sleep deprivation was associated with anger,fatigue,and stress.Therefore,to clarify the inducing factors of epileptic seizure,avoid the inducing factors as much as possible,reduce the harm caused by seizures,and improve the quality of life of patients.
引文
1中国抗癫痫协会.临床诊疗指南-癫痫病分册.北京:人民卫生出版社,2015,2:1-5.
2尹延肖,余年,狄晴.癫痫发作诱发因素的研究现状.癫痫杂志,2017,3(4):310-314.
3 Nakken KO,Solaas MH,Kjeldsen MJ,et al. Which seizureprecipitating factors do patients with epilepsy most frequently report? EpilepsyBehav,2015,6(1):85-89.
4 Sperling MR,Schilling CA,Glosser D,et al.Self-perception of seizure precipitants and their relation to anxiety level,depression,and health locus of control in epilepsy.Seizure,2008,17:302-307.
5 Balamurugan E,Aggarwal M,Lamba A,et al.Perceived trigger factors of seizures in persons with epilepsy.Seizure,2013,22:743-747.
6 Samsonsen C,Sand T,Br?then G,et al.The impact of sleep loss on the facilitation of seizures:a prospective case-crossover study.Epilepsy Res,2016,127:260-266.
7李冬青,杨健.儿童睡眠与癫痫.世界睡眠与医学杂志,2015,2(5):302-307.
8孙红斌,冯芹,范真,等.睡眠与癫痫关系的研究进展.临床神经病学杂志,2016,9(4):308-310.
9孙彩霞,孙美珍,刘丹丹,等.睡眠与癫痫.中华脑科疾病与康复杂志,2016,6(3):181-183.
10杨景晖,汤春晖.儿童特发性癫痫与睡眠的相关性研究.现代预防医学,2012,39(11):2713-2714.
11 Lunardi Mdos S,Sukys-Claudino L,Guarnieri R.Seizure precipitants and inhibiting factors in mesial temporal lobe epilepsy.J Neurol Sci,2011,308(1-2):21-24.
12 van Campen JS,Jansen FE,de Graan PN,et al.Earlylife stress in epilepsy:a seizure precipitant and risk factor for epileptogenesis.Epilepsy Behav,2014,38:160-171.
13胡薇薇,陈忠.应激在癫痈发病中的作用.国外医学(神经病学神经外科学分册),2003,30(4):312-313.
14冯瑞华.小儿癫痫发作与睡眠和饮食的相关性研究.世界睡眠医学杂志,2018,5(7):858-860.
15方筱静,王薇薇,吴逊.酒、咖啡、烟对癫痫的影响.医学研究杂志,2016,45(1):184-186.
2尹延肖,余年,狄晴.癫痫发作诱发因素的研究现状.癫痫杂志,2017,3(4):310-314.
3 Nakken KO,Solaas MH,Kjeldsen MJ,et al. Which seizureprecipitating factors do patients with epilepsy most frequently report? EpilepsyBehav,2015,6(1):85-89.
4 Sperling MR,Schilling CA,Glosser D,et al.Self-perception of seizure precipitants and their relation to anxiety level,depression,and health locus of control in epilepsy.Seizure,2008,17:302-307.
5 Balamurugan E,Aggarwal M,Lamba A,et al.Perceived trigger factors of seizures in persons with epilepsy.Seizure,2013,22:743-747.
6 Samsonsen C,Sand T,Br?then G,et al.The impact of sleep loss on the facilitation of seizures:a prospective case-crossover study.Epilepsy Res,2016,127:260-266.
7李冬青,杨健.儿童睡眠与癫痫.世界睡眠与医学杂志,2015,2(5):302-307.
8孙红斌,冯芹,范真,等.睡眠与癫痫关系的研究进展.临床神经病学杂志,2016,9(4):308-310.
9孙彩霞,孙美珍,刘丹丹,等.睡眠与癫痫.中华脑科疾病与康复杂志,2016,6(3):181-183.
10杨景晖,汤春晖.儿童特发性癫痫与睡眠的相关性研究.现代预防医学,2012,39(11):2713-2714.
11 Lunardi Mdos S,Sukys-Claudino L,Guarnieri R.Seizure precipitants and inhibiting factors in mesial temporal lobe epilepsy.J Neurol Sci,2011,308(1-2):21-24.
12 van Campen JS,Jansen FE,de Graan PN,et al.Earlylife stress in epilepsy:a seizure precipitant and risk factor for epileptogenesis.Epilepsy Behav,2014,38:160-171.
13胡薇薇,陈忠.应激在癫痈发病中的作用.国外医学(神经病学神经外科学分册),2003,30(4):312-313.
14冯瑞华.小儿癫痫发作与睡眠和饮食的相关性研究.世界睡眠医学杂志,2018,5(7):858-860.
15方筱静,王薇薇,吴逊.酒、咖啡、烟对癫痫的影响.医学研究杂志,2016,45(1):184-186.