中国西北农村65岁及以上活动性惊厥癫痫患者癫痫治疗缺口及其相关因素

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Seizure-European Journal of Epilepsy Pub Date : 2025-04-22 DOI:10.1016/j.seizure.2025.04.015

Bofei Tan , Qiang Liu , Jianming Wu , Xianrui Xu , Xu Wang , Pingping Lei , Mengyun Li , Fei Huang , Qing Zhang

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引用次数: 0

摘要

目的探讨中国西北农村≥65岁活动性惊厥癫痫（ACE）患者的癫痫治疗缺口（ETG）及其相关因素。方法2008年至2021年间，我们在中国西北农村招募了ACE患者，作为中国政府启动的癫痫管理项目的一部分。来自423个乡镇卫生院的初级保健医生小组参加了该项目。每个地方初级卫生组织在研究期间通过训练有素的当地医生对当地社区的患者进行筛查。通过问卷访谈来确定ACE患者，并在调查过程中收集信息。本研究计算2012 - 2021年≥65岁ACE患者的ETG，采用logistic回归分析西北农村≥65岁ACE患者ETG的相关因素。结果共纳入480例≥65岁ACE患者，其中男性占62.7%。其中，176人未接受适当治疗，导致ETG为36.7%；在发病年龄为65岁的个体中，未接受适当治疗的比例明显高于接受适当治疗的比例（69.9%比60.9%,p = 0.047）；单因素分析表明，年龄≥65岁的ACE患者发病年龄≥65岁、癫痫持续时间≥20年、纳入前1年内发作频率12 ~ 23次可能与ETG相关(p <；0.05);在多因素分析中，≥65岁的ACE患者在纳入前1年内发作频率较高，为12 ~ 23次（OR = 1.733, 95% CI 1.031-2.940, p = 0.042）与ETG显著相关。结论西北农村老年ACE患者ETG发生率相对较小，约为36.7%。然而，对于起病年龄较小（65岁）、发作频率较高（纳入前1年内12-23次）的老年人，应加强ACE的预防和治疗，进一步缩小ETG。

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Epilepsy treatment gap and its associated factors in individuals aged 65 years and older with active convulsive epilepsy in rural Northwestern China

Purpose

We investigated the epilepsy treatment gap (ETG) and its associated factors in individuals aged≥65 years with active convulsive epilepsy(ACE) in rural Northwestern China.

Method

Between 2008 and 2021, We recruited individuals with ACE in rural Northwestern China as part of an epilepsy management project launched by the Chinese government. A team of primary care doctors from 423 township hospitals participated in the project. Each local primary health organization screens patients from the local community through well-trained local physicians within a study period. Questionnaire-based interviews were conducted to identify patients with ACE, with information collected during the survey. ETG in individuals aged≥65 years with ACE were calculated in the study from 2012 to 2021, and logistic regression analysis was employed to analyze associated factors of ETG in individuals aged≥65 years with ACE in rural northwestern China.

Results

A total of 480 individuals aged≥65 years with ACE (male, 62.7 %) were included. Of these, 176 did not receive appropriate treatment, resulting in an ETG of 36.7 %; Among individuals with an onset age of <65 years, a significantly larger proportion did not receive appropriate treatment compared to those who did receive appropriate treatment(69.9 % vs. 60.9 %, p = 0.047); Univariate analysis indicated that an onset age of <65 years, epilepsy duration of≥20 years, and higher seizure frequency of 12∼23 times within 1 year before inclusion may be associated with ETG in individuals aged≥65 years with ACE (p < 0.05); In multivariate analysis, higher seizure frequency of 12∼23 times within 1 year before inclusion (OR = 1.733,95 % CI 1.031–2.940, p = 0.042) were significantly associated with ETG in individuals aged≥65 years with ACE.

Conclusion

Northwestern China rural areas has relatively smaller ETG in the elderly with ACE,at about 36.7 %. However, efforts to prevent and treat ACE in the elderly with a younger onset age (<65 years) and higher seizure frequency (12–23 times within 1 year before inclusion) should be intensified to further narrow the ETG.

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来源期刊

Seizure-European Journal of Epilepsy 医学-临床神经学

CiteScore

5.60

自引率

6.70%

发文量

231

审稿时长

34 days

期刊介绍： Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.