本文關(guān)鍵詞：局灶性癲癇發(fā)作期心率變化危險(xiǎn)因素的臨床研究　出處：《蘇州大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 局灶性癲癇 發(fā)作期 心率變化 危險(xiǎn)因素

【摘要】：目的:通過視頻腦電-心電監(jiān)測(cè),研究局灶性癲癇發(fā)作期心率變化危險(xiǎn)因素,了解心血管功能的神經(jīng)調(diào)節(jié)機(jī)制,以便發(fā)病初期盡早控制癲癇發(fā)作,降低癲癇發(fā)作對(duì)心臟造成的損害。方法:我們回顧性分析蘇州大學(xué)附屬第一醫(yī)院2013年1月~2015年12月54例術(shù)前評(píng)估的局灶性癲癇患者183次臨床發(fā)作的視頻腦電-心電監(jiān)測(cè)資料,包括單純部分性發(fā)作25次,復(fù)雜部分性發(fā)作44次,部分性發(fā)作繼發(fā)全面強(qiáng)直-陣攣發(fā)作114次(除外原發(fā)性全面性發(fā)作)。我們收集視頻腦電-心電監(jiān)測(cè)下的局灶性癲癇患者安靜狀態(tài)下基礎(chǔ)心率(每次腦電發(fā)作起始前5分鐘)、發(fā)作期最大心率(瞬時(shí)的,計(jì)算最短的RR間期),計(jì)算局灶性癲癇發(fā)作期心率變化(發(fā)作期最大心率與基礎(chǔ)心率的差值)。評(píng)估性別、年齡、意識(shí)狀態(tài)、部位、側(cè)別、發(fā)作類型、癲癇病程、部分性發(fā)作繼發(fā)全面強(qiáng)直-陣攣發(fā)作的發(fā)作頻率(partial seizures with secondary generalized tonic-clonic seizure frequency,簡(jiǎn)稱sGTCS發(fā)作頻率)、抗癲癇藥物數(shù)量(number of anti-epileptic drugs,簡(jiǎn)稱AEDs數(shù)量)、病因這些因素對(duì)局灶性癲癇發(fā)作期心率變化的影響。結(jié)果:1、本研究發(fā)現(xiàn)年齡、意識(shí)狀態(tài)、發(fā)作類型、癲癇病程、sGTCS發(fā)作頻率對(duì)局灶性癲癇發(fā)作期心率變化的影響存在統(tǒng)計(jì)學(xué)差異,而性別、側(cè)別、部位、AEDs數(shù)量、病因?qū)衷钚园d癇發(fā)作期心率變化的影響無(wú)統(tǒng)計(jì)學(xué)意義。2、通過Spearman相關(guān)分析得出:年齡與局灶性癲癇發(fā)作期心率變化存在正相關(guān),即隨著年齡增長(zhǎng),癲癇發(fā)作心率增加更明顯。3、通過簡(jiǎn)單線性回歸分析得出:局灶性癲癇發(fā)作期心率變化與年齡、意識(shí)狀態(tài)、發(fā)作類型、sGTCS發(fā)作頻率存在線性回歸關(guān)系,進(jìn)一步多元線性回歸分析得出:年齡、發(fā)作類型、sGTCS發(fā)作頻率是局灶性癲癇發(fā)作期心率變化的獨(dú)立危險(xiǎn)因素,即年齡越大、部分性發(fā)作繼發(fā)全面強(qiáng)直-陣攣發(fā)作、sGTCS發(fā)作頻率≥4次/月是癲癇發(fā)作心臟損害的高危因素。結(jié)論:1、成人、睡眠期、部分性發(fā)作繼發(fā)全面強(qiáng)直-陣攣發(fā)作、癲癇病程5-10年、sGTCS發(fā)作頻率≥4次/月會(huì)引起局灶性癲癇發(fā)作期心率變化的顯著增加。2、年齡與局灶性癲癇發(fā)作期心率變化存在正相關(guān),即隨著年齡增長(zhǎng),癲癇發(fā)作心率增加更明顯。3、年齡、發(fā)作類型、sGTCS發(fā)作頻率是局灶性癲癇發(fā)作期心率變化顯著增加的獨(dú)立危險(xiǎn)因素,即年齡越大、部分性發(fā)作繼發(fā)全面強(qiáng)直-陣攣發(fā)作、sGTCS發(fā)作頻率≥4次/月是癲癇發(fā)作心臟損害的高危因素。所以,發(fā)病初期盡早控制癲癇發(fā)作,避免部分性發(fā)作泛化為全面強(qiáng)直-陣攣發(fā)作,或許在降低癲癇發(fā)作對(duì)心臟損害方面起著一定作用。
[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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