Şahin Oruç, Güneş Muzaffer
Aksaray University Faculty of Medicine Department of Neurology, Aksaray, Turkiye.
Aksaray University Faculty of Medicine Department of Neurology, Aksaray, Turkiye.
Epilepsy Behav. 2025 Feb;163:110232. doi: 10.1016/j.yebeh.2024.110232. Epub 2024 Dec 30.
Status epilepticus (SE) is a severe neurological condition associated with a poor prognosis. Refractory status epilepticus (RSE) is a treatment-resistant form of SE with an even worse prognosis. The exact mechanisms underlying the development of RSE are not fully understood. The aim of this study was to investigate the factors contributing to the development of RSE in SE patients and to identify predictors of RSE occurrence.
This retrospective study was conducted on patients diagnosed with SE and RSE between 2014 and 2024. Demographic information, comorbid conditions, and blood sample data of the patients were recorded for statistical analysis. The statistical analyses used included the Mann-Whitney U test, Chi-square test, Fisher's exact test, ROC curve analysis, and logistic regression.
A total of 82 SE patients were included in the study. Of these, 44 were non-RSE patients (control group), and 38 were RSE patients. Significant differences were observed between the groups in terms of median age (p = 0.001), blood glucose level (p = 0.023), pan-immune inflammation value (PIV) (p = 0.002), Monocyte/Lymphocyte Ratio (MLR) (p = 0.009), Neutrophil/Albumin Ratio (NAR) (p = 0.003), Systemic Immune Inflammation Index (SII) (p = 0.013), Eosinophil/Lymphocyte Ratio (ELR) (p = 0.016), Eosinophil/Neutrophil Ratio (ENR) (p = 0.006), and Eosinophil/Monocyte Ratio (EMR) (p = 0.002). The multivariate logistic regression model identified the presence of arterial hypertension as the only factor significantly associated with the development of RSE (p < 0.001). In the ROC curve analysis, PIV (AUC = 0.696) and NAR (AUC = 0.689) were found to be predictive factors for RSE.
The findings obtained in the current study suggest that systemic inflammation and arterial hypertension may be associated with the progression of SE to RSE. Further research is needed to confirm these findings and integrate them into routine clinical practice.
癫痫持续状态（SE）是一种严重的神经系统疾病，预后较差。难治性癫痫持续状态（RSE）是SE的一种治疗抵抗形式，预后更差。RSE发生的确切机制尚未完全明确。本研究旨在探讨SE患者发生RSE的相关因素，并确定RSE发生的预测指标。
本回顾性研究纳入了2014年至2024年间诊断为SE和RSE的患者。记录患者的人口统计学信息、合并症情况及血液样本数据用于统计分析。所采用的统计分析方法包括曼-惠特尼U检验、卡方检验、费舍尔精确检验、ROC曲线分析和逻辑回归。
本研究共纳入82例SE患者。其中，44例为非RSE患者（对照组），38例为RSE患者。两组在年龄中位数（p = 0.001）、血糖水平（p = 0.023）、全免疫炎症值（PIV）（p = 0.002）、单核细胞/淋巴细胞比值（MLR）（p = 0.009）、中性粒细胞/白蛋白比值（NAR）（p = 0.003）、全身免疫炎症指数（SII）（p = 0.013）、嗜酸性粒细胞/淋巴细胞比值（ELR）（p = 0.016）、嗜酸性粒细胞/中性粒细胞比值（ENR）（p = 0.006）和嗜酸性粒细胞/单核细胞比值（EMR）（p = 0.002）方面存在显著差异。多因素逻辑回归模型确定动脉高血压的存在是与RSE发生显著相关的唯一因素（p < 0.001）。在ROC曲线分析中，发现PIV（AUC = 0.696）和NAR（AUC = 0.689）是RSE的预测因素。
本研究结果表明，全身炎症和动脉高血压可能与SE进展为RSE有关。需要进一步研究以证实这些发现并将其纳入常规临床实践。
