遗传性癫痫伴热性惊厥附加症患儿的疫苗接种风险分析  

Risk analysis of vaccination in children with genetic epilepsy combined with febrile seizures plus

作　　者：邵晓丽[1] 胡佳妮 姚银萍 俞栋 袁哲锋[2] Shao Xiaoli;Hu Jiani;Yao Yingping;Yu Dong;Yuan Zhefeng(Department of Pediatrics,Shaoxing People's Hospital&Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China;Department of Neurology,Children's Hospital Affiliated to School of Medicine,Zhejiang University,Hangzhou 31000,China)

机构地区：[1]浙江省绍兴市人民医院浙江大学绍兴医院儿科,312000 [2]浙江大学医学院附属儿童医院神经内科,绍兴310000

出　　处：《中华神经医学杂志》2020年第2期176-180,共5页Chinese Journal of Neuromedicine

基　　金：浙江省医药卫生科技项目(2017KY660、2020KY327)。

摘　　要：目的评估遗传性癫痫伴热性惊厥附加症(GEFS+)患儿的疫苗接种风险。方法选择浙江大学绍兴医院儿科自2016年5月至2019年5月收治的67例临床诊断为GEFS+的患儿,利用靶向二代测序技术将其分为SCN1A基因突变阳性组(SCN1A+组)11例及SCN1A基因突变阴性组(SCN1A-组)51例(剔除其余5例其他基因突变),回顾性分析2组患儿自出生至7岁龄疫苗接种后的惊厥发生次数以及体温变化。通过流式细胞术检测2组患儿惊厥发生后外周血白介素(IL)-2、IL-6、IL-10及肿瘤坏死因子-α(TNF-α)水平。结果11例SCN1A+组GEFS+患儿接种疫苗共34次,发生疫苗后惊厥次数为16次,发生率为47.00%;51例SCN1A-组GEFS+患儿共接种疫苗186次,发生疫苗接种后惊厥次数为12次,发生率为6.45%,差异有统计学意义(P<0.05)。SCN1A+组GEFS+患儿发生惊厥时体温为(38.06±0.57)℃,SCN1A-组GEFS+患儿发生惊厥时体温为(39.49±0.49)℃,差异有统计学意义(P<0.05)。SCN1A+组GEFS+患儿惊厥后外周血IL-6、IL-10表达水平分别为(96.80±25.05)pg/mL、(74.90±18.28)pg/mL,明显高于SCN1A-组GEFS+患儿的(72.97±4.81)pg/mL、(43.99±10.63)pg/mL,差异有统计学意义(P<0.05)。结论SCN1A+组GEFS+患儿比SCN1A-组GEFS+患儿更易发生疫苗接种后惊厥,且惊厥的热敏感现象更明显,细胞因子可能参与了惊厥的发生。Objective To assess the risk of vaccination in children with genetic epilepsy combined with febrile seizures plus(GEFS+).Methods Sixty-seven children with GEFS+,admitted to our hospital from May 2016 to May 2019,were enrolled in our study;using targeted second-generation sequencing technology,these patients were divided into positive SCN1A gene mutation group(SCN1A+group,n=11)and negative SCN1A gene mutation group(SCN1A-group,n=51)after kicking out 5 patients with other gene mutations.The frequencies of convulsion and changes of body temperature after vaccination were analyzed retrospectively in the two groups from birth to age of 7 years.The levels of interleukin(IL)-2,IL-6,IL-10 and tumor necrosis factor(TNF)-αin peripheral blood were measured by flow cytometry in both groups after seizures.Results Children from SCN1A+group were vaccinated for 34 times,with incidence of post-vaccine convulsion reaching 47%(16/34);children from SCN1A-group were vaccinated for 186 times,with incidence of post-vaccine convulsions reaching 6.45%(12/186);incidence of post-vaccine convulsion was statistically significant between the two groups(P<0.05).The mean body temperature in children from the SCN1A+group([38.06±0.57]℃)during convulsion was significantly lower than that in SCN1A-group([39.49±0.49]℃,P<0.05).Expressions of IL-6 and IL-10 in peripheral blood after convulsion in children from SCN1A+group(96.80±25.05 and 74.90±18.28)were significantly higher than those in SCN1A-group(72.97±4.81 and 43.99±10.63,P<0.05).Conclusion GEFS+children in the SCN1A+group are more prone to convulsion after vaccination than those in the SCN1A-group;cytokines may be involved in the development of convulsion.

关 键 词：SCN1A基因 癫痫 惊厥 疫苗 热敏感 

分 类 号：R72[医药卫生—儿科]