热性惊厥患儿24 h内惊厥反复发作的危险因素分析  

Risk factors analysis of recurrence of febrile seizures within 24 hours

作　　者：孙萌[1] 王江娅[1] 周冉 程亚颖[1] Sun Meng;Wang Jiangya;Zhou Ran;Cheng Yaying(Department of Pediatrics,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院儿科,石家庄050051

出　　处：《中国小儿急救医学》2023年第2期122-125,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨热性惊厥患儿24 h内惊厥反复发作的危险因素,为早期识别有危险因素的患儿并采取干预措施提供临床依据。方法选取2019年6月至2021年6月河北省人民医院儿科收治的384例热性惊厥患儿为研究对象,分为单次发作组和反复发作组,回顾性分析两组患儿的临床资料及惊厥反复发作的危险因素。结果384例热性惊厥患儿,年龄6个月~5岁,单次发作组296例,反复发作组88例,两组患儿在是否首次发作、首次发作的年龄、发作时体温、发作持续时间≥15 min、热性惊厥家族史及C-反应蛋白这6项指标,差异均有统计学意义(P均<0.05)。多因素Logistic回归分析发现,非首次发作(OR=2.085,95%CI 1.232~3.529,P=0.006)、首次发作年龄小(OR=0.970,95%CI 0.948~0.993,P=0.010)、发作持续时间≥15 min(OR=3.587,95%CI 1.497~8.596,P=0.004)、有热性惊厥家族史(OR=1.892,95%CI 1.126~3.180,P=0.016)是热性惊厥患儿24 h内反复出现惊厥发作的危险因素,ROC曲线分析4项危险因素同时存在预测价值更高(4项危险因素的曲线下面积分别为:0.791、0.635、0.704、0.727,联合模型的曲线下面积为0.974)。结论热性惊厥患儿24 h内惊厥反复发作的危险因素有非首次发作、首次发作年龄小、发作持续时间≥15 min、有热性惊厥家族史,4项危险因素同时存在的患儿更易出现反复发作,并可作为进行个体化预测的指标。Objective To investigate the risk factors of recurrence of febrile seizures within 24 hours,so as to provide clinical evidence for early identification of children with risk factors and taking interventions.Methods A total of 384 children with febrile seizures admitted to the Department of Pediatrics at Hebei General Hospital from June 2019 to June 2021 were selected as the study subjects,and were divided into single seizure group and recurrent seizures group.The clinical data of two groups and the risk factors of recurrent seizures were analyzed retrospectively.Results A total of 384 children,aging from six months to five years,were diagnosed with febrile seizures.There were 296 cases in the single seizure group and 88 cases in the recurrent seizures group.First seizure,the age of the first sezures,temperature,duration of seizure≥15 minutes,positive family history and C-reactive protein levels showed statistically significant differences between two groups(all P<0.05).Logistic regression analysis showed that non-first seizure(OR=2.085,95%CI 1.232-3.529,P=0.006),the age of first seizure(OR=0.970,95%CI 0.948-0.993,P=0.010),duration of seizure≥15 minutes(OR=3.587,95%CI 1.497-8.596,P=0.004)and positive family history(OR=1.892,95%CI 1.126-3.180,P=0.016)were risk factors of recurrence of febrile seizures within 24 hours.The ROC curve analysis showed that the combination of four risk factors had a higher predictive value,and the area under curve was 0.974.Conclusion Non-first seizure,the age of first seizure,cluration of seizure≥15 minutes and positive family history are the risk factors of recurrence of febrile seizures within 24 hours.Children with four risk factors are more likely to have recurrent seizure,and could be used as an indicator for individualized prediction.

关 键 词：热性惊厥 儿童 单次发作 反复发作 危险因素 

分 类 号：R720.597[医药卫生—急诊医学]