频繁发作和联合治疗会损害癫痫患者的生活质量。
Frequent seizures and polytherapy can impair quality of life in persons with epilepsy.
作者信息
Thomas Sanjeev V, Koshy Samuel, Nair C R Sudhakaran, Sarma Sankara P
机构信息
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
出版信息
Neurol India. 2005 Mar;53(1):46-50. doi: 10.4103/0028-3886.15054.
CONTEXT
Careful evaluation of pharmacotherapy, seizure control and quality of life (QOL) are helpful in improving epilepsy care but such data are relatively meager from developing countries.
AIMS
To audit pharmacotherapy, seizure control and QOL in persons with epilepsy and to identify factors associated with impaired QOL.
SETTINGS AND DESIGN & MATERIALS AND METHODS: The study was carried out using a cross-sectional design in the setting of a tertiary care epilepsy center in India. Persons with epilepsy with > 12 months follow-up at this Center and aged > 16 years were eligible for enrollment. Persons with other disabilities or pregnancy were excluded. Subjects were interviewed with a standard questionnaire and an adapted version of Quality of Life in Epilepsy - 31 (QOLIE-31). Data pertaining to treatment at the time of referral to this center was extracted from medical records.
STATISTICAL ANALYSIS USED
Chi-square test, analysis of variance and multiple regression analysis were carried out for statistical significance.
RESULTS
One hundred and twelve patients with epilepsy (59 males, mean age 31.2+/-10.7 years) were included. Forty-seven (42%) persons had Generalized Epilepsy (GE) and 65 persons (58%) had Localization-Related Epilepsy (LRE). At entry 24 persons (21.4%) were not on treatment and 59 persons (64.8%) had frequent seizures. At last follow-up 64 persons (57.1%) were seizure-free, 83 persons (74.1%) were on monotherapy and 29 were (25.9%) on polytherapy. Cost of drug at entry was INR 2276 (monotherapy) and INR 3629 (polytherapy) (45 INR = 1 USD). At the time of last follow-up, it was 1898 and 4929 respectively. QOLIE-31 Total Score (TQOL) ranged from 22.6 to 94.4 (mean 68.0 +/- 15.8). Multiple regression analysis showed significant correlation between low TQOL score and polytherapy (P=0.002) and occurrence of one or more seizures per month (P=0.001).
CONCLUSIONS
Frequent seizures and polytherapy are associated with lower QOL in persons with epilepsy.
背景
对药物治疗、癫痫控制及生活质量（QOL）进行仔细评估有助于改善癫痫护理，但来自发展中国家的此类数据相对较少。
目的
审核癫痫患者的药物治疗、癫痫控制及生活质量，并确定与生活质量受损相关的因素。
设置与设计及材料与方法
本研究采用横断面设计，在印度一家三级护理癫痫中心进行。在该中心随访超过12个月且年龄大于16岁的癫痫患者符合入选条件。排除患有其他残疾或怀孕的患者。采用标准问卷及癫痫生活质量-31（QOLIE-31）的改编版对受试者进行访谈。从病历中提取转诊至本中心时的治疗相关数据。
所用统计分析方法
采用卡方检验、方差分析及多元回归分析以确定统计学意义。
结果
纳入112例癫痫患者（59例男性，平均年龄31.2±10.7岁）。47例（42%）患有全身性癫痫（GE），65例（58%）患有局灶性相关癫痫（LRE）。入组时，24例（21.4%）未接受治疗，59例（64.8%）癫痫发作频繁。在最后一次随访时，64例（57.1%）无癫痫发作，83例（74.1%）接受单药治疗，29例（25.9%）接受联合治疗。入组时单药治疗的药物费用为2276印度卢比，联合治疗为3629印度卢比（45印度卢比 = 1美元）。在最后一次随访时，分别为1898和4929。QOLIE-31总分（TQOL）范围为22.6至94.4（平均68.0±15.8）。多元回归分析显示，TQOL得分低与联合治疗（P = 0.002）及每月发作一次或多次癫痫（P = 0.001）之间存在显著相关性。
结论
癫痫发作频繁及联合治疗与癫痫患者较低的生活质量相关。
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