儿童热性惊厥的常见呼吸道病原分析  

Analysis of Common Respiratory Pathogens of Febrile Convulsion in Children

作　　者：林碧云 施晓容[1] 林希[1] 吴斌[1] 陈素清[1] LIN Biyun;SHI Xiaorong;LIN Xi;WU Bin;CHEN Suqing(Department of Pediatrics,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院儿科,福州350005

出　　处：《福建医科大学学报》2020年第6期449-453,共5页Journal of Fujian Medical University

摘　　要：目的分析热性惊厥患儿呼吸道病原的分布特点及呼吸道病原感染与热性惊厥的关系。方法收集2017年1月—2019年12月249例热性惊厥患儿的临床资料,通过咽拭子检测呼吸道病原体抗原和(或)血清检测IgM抗体,分析不同病原体与热性惊厥的发作类型、复发、年龄、家族史等临床特征的关系。结果249例热性惊厥患儿完成了呼吸道病原学检测,病原检出率为76.7%(191/249),其中检出率最高的病原分别是乙型流感病毒49.80%(124/249),肺炎支原体31.73%(79/249)和甲型流感病毒30.12%(75/249)。甲型流感病毒在复杂型热性惊厥中的检出率(42.4%)比在单纯型热性惊厥中的检出率(22.9%)高(P<0.05),发生复杂型热性惊厥的比值比(OR值)为1.707(1.25,2.33)(P<0.05)。呼吸道病原检出数量在热性惊厥临床特点(包括再次发作、临床发作类型、家族史)的差别无统计学意义(P>0.05)。所检测病原与热性惊厥的再发、家族史、年龄无统计学意义(P>0.05)。结论流感病毒(包括甲型和乙型流感病毒)是热性惊厥儿童中检出率最高的呼吸道病原,复杂型热性惊厥儿童中甲型流感病毒的阳性率最高。开展流感病毒疫苗接种能降低流感的发病率,可能减少儿童热性惊厥发生。Objective To analyze the distribution characteristics of respiratory pathogens in children with febrile seizures(FS)and the relationship between pathogen and FS,in order to take appropriate preventive measures and develop follow-up strategies.Method Collect clinical data on 249 cases of FS from January 2017 to December 2019,detect respiratory pathogen antigens by pharyngeal swabs and/or serum IgM antibody tests,and analyze the relationship between different pathogens and clinical characteristics such as type of FS,recurrence,age,family history,ect.Results A total of 249 patients completed respiratory pathogen testing,the detection rate was 76.7%(191/249),of which the highest was 49.80%(124/249)for Influenza B virus,31.73%(79/249)for mycoplasma pneumoniae and 30.12%(75/249)for influenza A virus.The detection rate of influenza A virus in complex FS(42.4%)was higher than that in simple FS(22.9%)(P<0.05),and the odds ratio(OR)for complex FS was 1.707(1.25,2.33)(P<0.05).There was no statistically significant difference between the number of respiratory pathogens and the clinical features(including recurrence,type of FS,family history)(P>0.05).There was no significant correlation between the pathogens and the recurrence,family history and age(P>0.05).Conclusion Influenza viruses(including finfluenza A and B viruses)are the most highly detected respiratory pathogens in children with FS,and influenza A virus has the highest positive rate among complex FS.Vaccination against influenza viruses can reduce the incidence of infuenza,may reduce the incidence of FS in children.

关 键 词：儿童 惊厥 发热性 呼吸系统 呼吸系病毒 呼吸道感染 流感 人 

分 类 号：R322.3[医药卫生—人体解剖和组织胚胎学] R441.3[医药卫生—基础医学]