急性缺血性脑卒中后发生癫痫相关认知障碍的特点及危险因素分析

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Abstract Objective To analyze the characteristics and risk factors of epilepsy related cognitive impairment after acute ischemic stroke,so as to take measures for intervention as early as possible.Methods From January 2017 to January 2020,100 patients with epilepsy after acute ischemic stroke treated in the Second Hospital of Chaoyang were selected and their clinical medical data were analyzed retrospectively.Within one month after the first seizure after acute ischemic stroke,the cognitive function of the patients was assessed by mini mental state examination (MMSE).The patients were divided into cognitive impairment group and non-cognitive impairment group according to the MMSE score.The general data (gender,age,education level,severity of acute ischemic stroke,stroke location,etc.) and laboratory indexes (serum total cholesterol,triglyceride,high density lipoprotein [HDL-C],low density lipoprotein [LDL-C],blood uric acid [UA],etc.) of the two groups were compared.The characteristics of epilepsy related cognitive impairment after acute ischemic stroke were analyzed,and multivariate Logistic regression was used to analyze the risk factors of epilepsy related cognitive impairment after acute ischemic stroke.Results Among the 100 patients,45 (45.00%) patients with cognitive impairment were included in the cognitive impairment group,and 55 (55.00%) patients without cognitive impairment were included in the non-cognitive impairment group.The age,National Institute of Health stroke scale(NIHSS) score,cortical location,multifocal,seizure type (tonic spasm),seizure frequency (≥1 time/d) in the cognitive impairment group were higher than those in the non-cognitive impairment group,the differences were statistically significant (P<0.05).There were no significant differences in gender,education level,body mass index,smoking history,drinking history,cerebral infarction history and basic diseases between the two groups (P>0.05).The levels of serum total cholesterol and hypersensitive C-reactive protein (hs-CRP) in the cognitive impairment group were higher than those in the non-cognitive impairment group,the differences were statistically significant (P<0.05).There were no statistically significant differences in triglyceride,HDL-C,LDL-C,UA,serum creatinine (SCr),blood urea nitrogen (BUN),D-dimer,fibrinogen and homocysteine (Hcy) between the two groups (P>0.05).The results of multivariate Logistic regression analysis showed that age (β=0.656,OR=1.518,95%CI=1.301,2.829),severity of acute ischemic stroke (β=1.470,OR=5.384,95%CI=2.515,11.674),stroke location (β=1.681,OR=6.441,95%CI=2.451,18.568),seizure type(tonic spasm) (β=2.112,OR=7.165,95%CI=1.876,22.417),seizure frequency (≥1 time/d) (β=5.521,OR=11.230,95%CI=4.526,29.813),serum total cholesterol (β=0.704,OR=2.031,95%CI=1.201,3.986) and hs-CRP (β=1.118,OR=3.061,95%CI=1.003,8.754) were the risk factors of epilepsy related cognitive impairment after acute ischemic stroke(P<0.05).Conclusion Patients with epilepsy related cognitive impairment after acute ischemic stroke are older,have higher NIHSS score,have more stroke sites in the cortex,have a wide range of stroke,have more seizure types of tonic spasm,have higher seizure frequency,have higher levels of serum total cholesterol and hs-CRP in laboratory indexes,and the severity of ischemic stroke,the location of the stroke,the type of epilepsy (tonic spasm),the frequency of epilepsy,total serum cholesterol,and hs-CRP are all risk factors that affect its onset,and clinical attention should be paid.

Key words： Acute ischemic stroke Epilepsy Cognitive impairment Risk factors

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	LU Yan

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LU Yan. Characteristics and risk factors analysis of epilepsy related cognitive impairment after acute ischemic stroke[J]. 中国当代医药, 2021, 28(4): 13-17.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I4/13

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