儿童良性癫痫伴中央颞区棘波药物疗效不佳的影响因素分析

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摘要目的分析儿童良性癫痫伴中央颞区棘波（BECT）的临床特征和脑电图特点，探讨其药物疗效不佳的影响因素。方法回顾性分析2016年1月～2018年12月我院新诊断的101 例BECT 患儿的临床资料（包括低龄化起病、发作频次、发作形式、发作时间、热性惊厥史、惊厥家族史）及脑电图特点[包括棘/尖波（棘/尖慢复合波）放电、放电时期、放电泛化]。所有患儿确诊以后均予抗癫痫药物规范治疗，并完成至少1年随访。随访内容包括癫痫控制情况、有无新的发作形式、脑电图演变等。依据治疗1年后是否还有癫痫发作，将其分为无发作组（83 例）和药物疗效不佳组（18 例），分析两组治疗前的临床特征、脑电图特点等差异以及影响药物疗效不佳的因素。结果两组的低龄起病、发作频次及发作形式比较，差异有统计学意义（P＜0.05）；两组的发作时间、热性惊厥史及惊厥家族史比较，差异无统计学意义（P＞0.05）。多因素Logistic 回归分析，结果显示，发作频次是药物疗效不佳的影响因素（P＜0.05）。结论 BECT 大部分预后良好，其药物疗效与低龄起病（＜5 岁）、发作频次及发作形式有关，其中发作频次是药物疗效不佳的影响因素。

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关键词 ：儿童良性癫痫伴中央颞区棘波, 临床特征, 脑电图, 药物疗效

Abstract：Objective To analyze the clinical features and electroencephalogram (EEG) characteristics of benign epilepsy of childhood with centrotemporal spikes (BECT), and to discuss the influencing factors of poor drug response. Methods A retrospective analysis was conducted on the clinical data (including low age of onset, frequency of seizures, type of seizures, time of seizures, history of fever seizure, and family history of convulsions) and EEG characteristics (including spur/spike [spine/slow complex wave]discharge, discharge period, discharge generalization) of 101 children newly diagnosed with BECT in our hospital from January 2016 to December 2018.All subjects were routinely treated with antiepileptic drugs, and followed up for at least one year, including control of seizure, new form of seizure and evolution of EEG.The subjects were then divided into seizure free group (83 cases) and poor drug response group (18 cases) according to whether there were seizures after one year of treatment.The differences in clinical characteristics and EEG characteristics before treatment between the two groups as well as the factors influencing poor drug response were analyzed. Results There were statistically significant differences in the low age of onset, frequency of seizures, and type of seizures between the two groups (P＜0.05).There were no statistically significant differences in time of seizures, history of fever seizure, and family history of convulsions between the two groups (P＞0.05).Multivariate Logistic regression analysis showed that the frequency of seizures was the influencing factor of poor drug response (P＜0.05). Conclusion BECT generally has a good prognosis, and its drug response is related to low age of onset (＜5 years old), the frequency of seizures, and the type of seizures, among them, the frequency of seizures is an influential factor for poor drug response.

Key words： Benign epilepsy of childhood with centrotemporal spikes Clinical features Electroencephalogram Drug response

基金资助:广东省佛山市科技局科研项目（2018AB000231）

通讯作者: 刘志刚，主任医师，研究方向：小儿神经疾病

作者简介: 周杏，硕士，研究方向：小儿神经疾病

引用本文:

周杏；刘志刚；董诗伟. 儿童良性癫痫伴中央颞区棘波药物疗效不佳的影响因素分析[J]. 中国当代医药, 2020, 27(15): 142-145转149.
ZHOU Xing； LIU Zhi-gang； DONG Shi-wei. Analysis of the influencing factors of poor drug response of benign epilepsy of childhood with centrotemporal spikes. 中国当代医药, 2020, 27(15): 142-145转149.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I15/142

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