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癫痫患者的无症状菌尿症:一项横断面研究。

The asymptomatic bacteriuria in the patients with epilepsy: A cross-sectional study.

作者信息

Chen Yu-Shiue, Weng Tzu-Ping, Lai Ming-Chi, Huang Chin-Wei

机构信息

Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Infection Control, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Heliyon. 2024 Nov 19;10(23):e40534. doi: 10.1016/j.heliyon.2024.e40534. eCollection 2024 Dec 15.

Abstract

BACKGROUND

Epilepsy is a chronic neurological disorder characterized by repetitive unprovoked seizures. While certain anti-seizure medications have been linked to urinary tract infections, limited information exists on the occurrence and risk factors of asymptomatic bacteriuria (ASB) in individuals with epilepsy. This study aims to investigate the prevalence and factors associated with ASB in patients with epilepsy.

METHOD

A cross-sectional study was conducted, enrolling patients with epilepsy and healthy adults as controls. All participants underwent urine analyses during follow-ups at an epilepsy special clinic. Data on epilepsy-related factors were thoroughly collected and analyzed. Descriptive statistics and a logistic regression model were employed to identify the prevalence and risk factors of ASB in patients with epilepsy.

RESULTS

The study encompassed 200 patients with epilepsy, compared to 100 healthy controls. The prevalence of ASB in the epilepsy group was significantly higher than in the healthy controls (34.0 % versus 16.2 %,  = 0.001). The logistic regression model identified factors statistically associated with ASB in epilepsy, including gender (female) ( < 0.001), proteinuria ( = 0.021), and the use of oxcarbazepine ( = 0.011). Interestingly, lamotrigine demonstrated a protective effect against ASB ( = 0.023), along with age ( = 0.015) in this study. Moreover, patients with and without ASB exhibited a similar rate of 12 months of seizure freedom.

CONCLUSION

The prevalence of ASB is elevated in epilepsy, with identified risk factors including gender (female), proteinuria, and the use of the anti-seizure medication oxcarbazepine. Lamotrigine was found to be protective. These findings underscore the importance of clinician awareness, and careful monitoring of anti-seizure medication therapy.

摘要

背景

癫痫是一种慢性神经系统疾病,其特征为反复出现无诱因的癫痫发作。虽然某些抗癫痫药物与尿路感染有关,但关于癫痫患者无症状菌尿(ASB)的发生情况和危险因素的信息有限。本研究旨在调查癫痫患者中ASB的患病率及相关因素。

方法

进行了一项横断面研究,纳入癫痫患者并以健康成年人作为对照。所有参与者在癫痫专科门诊随访期间接受尿液分析。全面收集并分析与癫痫相关因素的数据。采用描述性统计和逻辑回归模型来确定癫痫患者中ASB的患病率和危险因素。

结果

该研究纳入了200例癫痫患者和100例健康对照。癫痫组中ASB的患病率显著高于健康对照组(34.0%对16.2%,P = 0.001)。逻辑回归模型确定了癫痫中与ASB有统计学关联的因素,包括性别(女性)(P < 0.001)、蛋白尿(P = 0.021)以及使用奥卡西平(P = 0.011)。有趣的是,在本研究中,拉莫三嗪对ASB具有保护作用(P = 0.023),年龄也有此作用(P = 0.015)。此外,有和没有ASB的患者癫痫发作无发作12个月的比例相似。

结论

癫痫患者中ASB的患病率升高,已确定的危险因素包括性别(女性)、蛋白尿以及使用抗癫痫药物奥卡西平。发现拉莫三嗪具有保护作用。这些发现强调了临床医生提高认识以及仔细监测抗癫痫药物治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e600/11625297/5109883405ef/gr1.jpg

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