脑电图及神经影像学在小儿热性惊厥中的临床应用价值  

Clinical value of electroencephalogram and neuroimaging in children with febrile seizures

作　　者：徐娜[1] 黄志[1] 

机构地区：[1]重庆医科大学附属儿童医院神经内科儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室,重庆400010

出　　处：《重庆医科大学学报》2018年第2期192-197,共6页Journal of Chongqing Medical University

摘　　要：目的:探讨脑电图(electroencephalogram,EEG)及神经影像学(computed tomography,CT或magnetic resonance imaging,MRI)检查在小儿热性惊厥(febrile seizures,FS)中的临床应用价值。方法:(1)根据临床特征将FS分为单纯性热性惊厥(simple febrile seizures,SFS)和复杂性热性惊厥(complex febrile seizures,CFS);根据随访结果,分为FS继发癫痫组与FS未继发癫痫组;(2)426例FS儿童于发作后2周内行首次EEG,并根据病情定期随访,92例行CT,310例行MRI,采用卡方检验和logistic回归分析,分析总结EEG、CT或MRI与FS类型、临床特征以及是否继发癫痫的关系。结果:(1)FS儿童首次EEG异常71例,随访后异常138例,两者比较有明显差异(P=0.000);其中SFS组和CFS组分别由22例、49例增至26例、112例,复查前、后比较,SFS组无明显差异(P=0.102),CFS组有明显差异(P=0.008);(2)根据随访结果,EEG异常率在SFS组(26/426)与CFS组(112/426)间、FS继发癫痫组(97/127)与FS未继发癫痫组(41/299)间比较存在明显差异(P=0.001,P=0.001);(3)CT、MRI异常率在SFS组(CT,8/92;MRI,9/310)与CFS组(CT,5/92;MRI,28/310)间、FS继发癫痫组(CT,3/16;MRI,16/110)与FS未继发癫痫组(CT,10/76;MRI,21/200)间比较均无明显差异(P=0.574,P=0.755,P=0.559,P=0.293);(4)CT/MRI与EEG检查异常率之间无相关性(P=0.836,P=0.557)。结论:(1)对CFS儿童定期随访EEG有较大的临床应用价值,但对SFS儿童其价值有限;(2)CT/MRI对发育正常的FS儿童的临床应用价值有限,不需要常规进行。Objective：To explore the clinical value of electroencephalograms（EEG）and neuroimaging（CT or MRI）in children with febrile seizures（FS）. Methods：（1）According to clinical features,the children with FS were classified as simple febrile seizures（SFS）and complex febrile seizures（CFS）. According to the follow-up results,the children with FS were classified as children with epilepsy group and children without epilepsy group.（2）The initial EEGs were recoreded within two weeks after onset in 426 children with FS.And EEGs were followed up regularly. A total of 92 children with FS underwent CT and 310 underwent MRI. Chi-square test and Logistic regression analysis were used to analyze the relationship between EEG,CT/MRI and types of FS,clinical features,and secondary epilepsy. Results：（1）The abnormal cases of initial EEGs and follow-up EEGs were 71 and 138 respectively,with significant differences（P=0.000）. The abnormal cases of EEG in SFS group and CFS group ranged from 22 to 26,from 49 to 112 respectively.Compared with follow-up results before and after,there was no significant difference in SFS group（P=0.102）,and the difference was significant in CFS group（P=0.008）.（2）In the follow-up results,the abnormal rate of EEGs were significant different in SFS group（26/426） and CFS group（112/426）,children with epilepsy group（97/127）and in children without epilepsy group（41/299）（P=0.001,P=0.001）.（3）The abnormal rate of CT/MRI were not significant different in SFS group（CT,8/92;MRI,9/310）,CFS group（CT,5/92;MRI,28/310）,children with epilepsy group（CT,3/16;MRI,16/110） and in children without epilepsy group（CT,10/76;MRI,21/200）（P=0.574,P=0.755,P=0.559,P=0.293）.（4）The abnormalities of CT/MRI were not correlated with the abnormalities of EEG（P =0.836,P =0.557）. Conclusion：（1） EEG,especially the regular follow-up of EEG,has a greater clinical value for children with CFS,and is of limited value for children with SFS.（2）CT/MRI

关 键 词：热性惊厥 单纯性热性惊厥 复杂性热性惊厥 脑电图 神经影像学 癫痫 

分 类 号：R741.044[医药卫生—神经病学与精神病学]