细菌性颅内感染早发性癫痫的影响因素分析

Influencing factors for early-onset epilepsy secondary to bacterial intracranial infection

摘要:

目的 探讨细菌性颅内感染继发早发性癫痫（EE）的影响因素。方法 回顾性分析2014年12月至2024年12月厦门大学附属中山医院和龙岩市第二医院收治的213例细菌性颅内感染患者的临床资料。根据是否发生EE分为EE组（23例）和非EE组（190例）。结果 EE组入院体温≥38.5 ℃和入院格拉斯哥昏迷量表（GCS）评分≤8分的比例高于非EE组（P<0.05）。EE组血清乳酸脱氢酶、脑脊液葡萄糖、脑脊液微量总蛋白与非EE组患者比较，差异有统计学意义（P<0.05）。单因素Logistic回归分析显示，入院体温≥ 38.5 ℃、入院GCS评分≤8分、血清电解质异常以及血清乳酸脱氢酶、脑脊液葡萄糖、脑脊液微量总蛋白水平与继发EE相关。多因素Logistic回归分析显示，高血清乳酸脱氢酶、低脑脊液葡萄糖、高脑脊液微量总蛋白是继发EE的危险因素。结论 高血清乳酸脱氢酶、低脑脊液葡萄糖、高脑脊液微量蛋白是细菌性颅内感染继发EE的危险因素。

Abstract:

Objective To investigate the influencing factors for early-onset epilepsy （EE） secondary to bacterial intracranial infection.Methods A retrospective analysis was performed for the clinical data of 213 patients with bacterial intracranial infection who were admitted to Zhongshan Hospital， Xiamen University and The Second Hospital of Longyan from December 2014 to December 2024. According to the presence or absence of EE， the patients were divided into EE group with 23 patients and non-EE group with 190 patients.Results Compared with the non-EE group， the EE group had a significantly higher proportion of patients with a body temperature of ≥38.5 ℃ or a Glasgow Coma Scale （GCS） score of ≤8 on admission （P<0.05）. There were significant differences between the EE group and the non-EE group in serum lactate dehydrogenase， cerebrospinal fluid glucose， and cerebrospinal fluid protein （P<0.05）. The univariate Logistic regression analysis showed that a body temperature of ≥38.5 ℃ on admission， a GCS score of ≤8 on admission， abnormal serum electrolytes， high serum lactate dehydrogenase， low cerebrospinal fluid glucose， and high cerebrospinal fluid protein were associated with secondary EE. The multivariate Logistic regression analysis showed that high serum lactate dehydrogenase， low cerebrospinal fluid glucose， and high cerebrospinal fluid protein were risk factors for secondary EE.Conclusions High serum lactate dehydrogenase， low cerebrospinal fluid glucose， and high cerebrospinal fluid protein are influencing factors for EE secondary to bacterial risk infection.