阿司匹林对急性大动脉主干闭塞性脑梗死后癫痫发作的影响

Effect of aspirin on epileptic seizures after acute large artery main trunk occlusive cerebral infarction

摘要:

目的 分析阿司匹林对急性大动脉主干闭塞性脑梗死后癫痫发作的影响。方法 回顾性选取2019年1月—2022年12月于连云港市第一人民医院神经内科住院，诊断为急性大动脉主干闭塞性脑梗死，并为首次发作的患者384例。收集患者临床资料，以电话随访或上门随访的形式对患者开展为期2年的随访。依据患者是否出现癫痫，将其分为发作组与未发作组。采用多因素一般Logistic回归模型分析急性大动脉主干闭塞性脑梗死后癫痫发作的影响因素。结果 最终295例患者完成随访，其中，90例（30.51%）患者发生癫痫。发作组入院美国国立卫生研究院卒中量表（NIHSS）评分、出血转化率、梗死累及顶叶率和颞叶率均高于未发作组（P <0.05），阿司匹林使用率低于未发作组（P <0.05）。多因素一般Logistic回归分析结果显示：入院NIHSS评分高［O^R =1.428（95% CI：1.241，1.637）］、出血转化［O^R =3.976（95% CI：1.713，9.123）］、梗死累及顶叶［O^R =2.125（95% CI：1.095，4.120）］、梗死累及颞叶［O^R =5.470（95% CI：2.608，11.512）］均为急性大动脉主干闭塞性脑梗死后癫痫发作的危险因素（P <0.05），应用阿司匹林［O^R =0.182（95% CI：0.087，0.401）］为急性大动脉主干闭塞性脑梗死后癫痫发作的保护因素（P <0.05）。不同药物治疗急性大动脉主干闭塞性脑梗死患者癫痫发作次数等级的比较，差异无统计学意义（P >0.05）。结论 阿司匹林可能降低急性大动脉主干闭塞性脑梗死后癫痫的发生。

Abstract:

Objective To analyze the effect of aspirin on epileptic seizures after acute large artery main trunk occlusive cerebral infarction.Methods A retrospective method was adopted. 384 patients diagnosed with acute large artery main trunk occlusive cerebral infarction and having their first seizure were selected from the Neurology Department of Lianyungang First People's Hospital from January 2019 to December 2022. Clinical data of the patients were collected. A 2-year follow-up was conducted through telephone or on-site follow-up. The patients were divided into the seizure group and the non-seizure group based on whether they had epileptic seizures. Multivariate general Logistic regression analysis was used to explore the influencing factors of epileptic seizures after acute large artery main trunk occlusive cerebral infarction.Results A total of 295 patients completed the final follow-up. Among them, 90 patients (accounting for 30.51%) had epileptic seizures. The NIHSS scores at admission, bleeding conversion rate, rate of infarction involving the parietal lobe, and temporal lobe rate in the seizure group were higher than those in the non-seizure group (P < 0.05), and the aspirin usage rate was lower than that in the non-seizure group (P < 0.05).. Multivariate general Logistic regression analysis showed that high NIHSS score at admission [O^R = 1.428 (95% CI: 1.241, 1.637) ], bleeding conversion [O^R = 3.976 (95% CI: 1.713, 9.123) ], infarction involving the parietal lobe [O^R = 2.125 (95% CI: 1.095, 4.120) ], and infarction involving the temporal lobe [O^R = 5.470 (95% CI: 2.608, 11.512) ] were all risk factors for epileptic seizures after acute large artery main trunk occlusive cerebral infarction (P < 0.05), and aspirin use [O^R = 0.182 (95% CI: 0.087, 0.401) ] was a protective factor for epileptic seizures after acute large artery main trunk occlusive cerebral infarction (P < 0.05). Comparison of the frequency grades of epileptic seizures in patients with acute large artery main trunk occlusive cerebral infarction treated with different drugs showed no statistically significant difference (P > 0.05).Conclusion Aspirin may reduce the occurrence of epilepsy after acute large artery main trunk occlusive cerebral infarction.