儿童热性惊厥复发危险因素临床分析  

Clinical analysis of risk factors for seizure recurrence in children with febrile seizures

作　　者：杨军[1] 李水霞[1] 陈莉娜[2,3] 

机构地区：[1]四川省都江堰市人民医院新生儿科,四川都江堰611830 [2]四川大学华西第二医院儿科,四川成都610041 [3]出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《现代预防医学》2016年第24期4519-4522,共4页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(81200461)

摘　　要：目的探讨儿童热性惊厥(FS)复发的危险因素。方法选取2008年1月至2015年8月初次诊断为FS的患儿为研究对象,回顾性收集临床资料,采用单因素分析导致FS复发的影响因素,采用非条件多因素Logistic回归分析确定导致FS复发的独立危险因素。结果 1 261例初诊为FS的病例纳入研究,按是否复发将患儿分为复发组(n=453)及非复发组(n=808),2组患儿性别构成比、原发疾病、惊厥2周后脑电图变化等比较,差异无统计学意义(P>0.05),单因素分析结果显示复杂性FS、年龄小、惊厥时的体温低、次数多、持续时间长、发作前发热时间短、有家族FS史、缺铁性贫血、低钠血症、生活环境差异、围生期损害等11项指标与FS复发存在相关性,差异有统计学意义(P<0.05)。非条件多因素Logistic回归分析结果显示发病年龄小、发作时体温低、复杂性FS、发作前发热时间≤1 h、有家族FS史、合并症(缺铁性贫血/低钠血症)是导致FS复发的独立危险因素。结论儿童FS易复发,首发时应评估危险因素,给予适当的干预措施并密切随访。Objective This work was to investigate the risk factors for seizure recurrence in children with febrile seizures（FS）.Methods The children who were diagnosed as FS for the first time between January 2008 and August 2015 were included in this study, and their clinical information were collected retrospectively. The factors related to seizure recurrence were analyzed by univariate analysis.Unconditioned logistic regression analysis was applied to determine the independent risk factors of recurrent FS. Results 1A total of 1261 cases were included in the study. They were divided into the recurrence group（n=453） and the non-recurrence group（n=808）.The recurrence rate was 35.9%. The basic characteristics of the two groups such as sex ratio, the primary diseases and EEG findings 2 weeks after the first convulsion were comparable, without statistically significant difference（P〉 0.05）. 2The univariate analysis revealed that 11 factors were associated with seizure recurrence, including complex FS, young age, low temperature during convulsions, multiple seizures, long duration of seizure,short interval between the onset of fever and seizure, positive family history of FS, anemia due to iron deficiency,hyponatremia, poor living environment and perinatal brain injury, and the differences had statistical significance（ P〈 0.05）.3The unconditioned multivariable logistic regression analysis results revealed that the independent risk factors of recurrent FS included young age, low temperature during convulsions, complex FS, the less than one-hour interval between the onset of fever and seizure, positive family history of FS and complications（anemia due to iron deficiency and hyponatremia）.Conclusion Children with FS were prone to seizure recurrences. The risk factors should be evaluated upon their first convulsion.Appropriate management and careful follow-up are important.

关 键 词：热性惊厥 儿童 危险因素 复发 

分 类 号：R594.1[医药卫生—内科学]