迷走神经刺激术治疗儿童癫痫的疗效预测因素分析

目的探讨影响儿童癫痫患者迷走神经刺激术（VNS）疗效的可能因素。方法回顾性分析2014年1月—2021年1月在宣武医院功能神经外科行VNS的42例儿童癫痫患者的临床资料，电话随访方式记录患者的刺激电流强度和发作减少率。发作减少率≥50%的患者定义为应答者。分别使用Fisher确切概率法、χ2检验或单因素二元Logistic回归分析分类变量和连续变量，筛选应答可能的影响因素。将有统计学差异的预测因子纳入最终的二元Logistic回归分析。结果单因素分析结果显示性别、发作类型和核磁表现是患儿应答可能的影响因素(P＜0.05)。多因素二元Logistic回归结果发现性别和发作类型为儿童患者VNS应答的影响因素（P＜0.05)。结论男性和局灶性起源的癫痫患儿术后更可能获得≥50%的发作减少率。

Objective To explore the possible factors affecting the efficacy of vagus nerve stimulation(VNS) in children with epilepsy. Methods The clinical data of 42 children with epilepsy who underwent VNS in Department of Functional Neurosurgery, Xuanwu Hospital from January 2014 to January 2021 were analyzed retrospectively. The stimulation current intensity and seizure reduction rate were recorded by telephone follow-up. Patients with seizure reduction rate ≥50% were defined as respondents. Fisher’s precision probability test, χ2 test or univariate binary logistic regression analysis were used to analyze categorical variables and continuous variables, and screen the possible influencing factors of response. The predictors with statistical differences were included in the final binary logistic regression analysis. Results Univariate analysis showed that gender, seizure type and MRI findings were the possible influencing factors of children’s response(P<0.05). The results of multivariate binary logistic regression showed that gender and seizure type were the influencing factors of VNS response in children(P<0.05). Conclusion Males and those with focal seizure onset are more likely to achieve ≥50% seizure reduction rate after operation.