轻度胃肠炎伴婴幼儿良性惊厥和热性惊厥患儿血清锌水平与脑损伤的相关性研究  

Correlation between serum zinc and brain injury in infants with mild gastroenteritis complicated with benign infantile convulsion and febrile convulsion

作　　者：李春梅 刘振奎[1] 卢艳辉[1] 石蔚[1] 高娇娇 曹燕玲 刘俊芬[2] 马俊帅[3] Li Chunmei;Liu Zhenkui;Lu Yanhui;Shi Wei;Gao Jiaojiao;Cao Yanling;Liu Junfen;Ma Junshuai(Department of Pediatrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Nephrology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Laboratory Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院儿内科,河北张家口075000 [2]河北北方学院附属第一医院肾内科,河北张家口075000 [3]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《中华危重病急救医学》2023年第8期860-864,共5页Chinese Critical Care Medicine

基　　金：河北省卫生健康委员会青年科技项目(20211012);河北省张家口市科技计划项目(2021068D)。

摘　　要：目的:探讨轻度胃肠炎伴婴幼儿良性惊厥(BICE)和热性惊厥(FC)患儿血清锌水平与惊厥性脑损伤的相关性。方法:采用病例对照研究方法,选择2020年1月至2022年1月河北北方学院附属第一医院收治的120例轻度胃肠炎伴惊厥患儿作为研究对象,根据患儿惊厥类型分为BICE组和FC组。记录两组患儿血清锌水平、惊厥发作次数及持续时间、惊厥性脑损伤发生情况等数据;采用多因素Logistic回归分析筛选患儿发生惊厥性脑损伤的危险因素;采用Spearman相关法分析血清锌水平及惊厥临床特征与惊厥性脑损伤的相关性。结果:120例患儿住院期间发生BICE 81例,FC 39例。FC组患儿血清锌水平明显低于BICE组(μmol/L:39.24±6.50比48.65±7.21,P<0.01);BICE组和FC组惊厥发作次数≥2次的患儿血清锌水平均明显低于发作1次的患儿(μmol/L:BICE组为37.65±6.50比53.17±7.55,FC组为30.27±5.58比44.16±7.57,均P<0.01),惊厥发作持续时间≥5 min的患儿血清锌水平明显低于发作持续时间<5 min的患儿(μmol/L:BICE组为38.75±6.74比51.21±7.58,FC组为31.08±5.46比45.19±7.25,均P<0.01),且FC组不同惊厥发作次数及持续时间患儿血清锌水平明显低于BICE组(均P<0.01)。120例患儿中发生惊厥性脑损伤9例,发生率7.50%。BICE组患儿惊厥性脑损伤发生率为1.23%(1/81),明显低于FC组的20.51%(8/39,P<0.01)。惊厥性脑损伤患儿血清锌水平显著低于非脑损伤患儿(μmol/L:28.50±5.00比60.22±7.31,P<0.01),其惊厥发作次数较非脑损伤患儿明显增加(发作次数≥2次比例:100.00%比1.80%,P<0.01),惊厥发作持续时间也较非脑损伤患儿明显延长(发作持续时间≥5 min比例:100.00%比11.71%,P<0.01)。多因素Logistic回归分析显示,血清锌水平降低〔优势比(OR)=2.147,95%可信区间(95%CI)为1.354~3.403〕、惊厥发作次数增加(OR=3.452,95%CI为1.266~9.417)、惊厥发作持续时间延长(OR=3.117,95%CI为1.326~7.327)是轻度胃肠炎伴惊厥患儿�Objective To investigate the association between serum zinc levels and convulsive brain injury in infants with mild gastroenteritis complicated with benign infantile seizures(BICE)and febrile seizures(FC).Methods A case-control study method was conducted.120 children with mild gastroenteritis and convulsion admitted to the First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were enrolled as the research subjects.They were divided into BICE group and FC group according to the type of convulsion.The serum zinc level,the frequency and duration of convulsion,and the occurrence of convulsive brain injury in the two groups were recorded.Multivariate Logistic regression analysis was used to screen the risk factors for convulsive brain injury.The Spearman correlation method was used to analyze the association between serum zinc levels,clinical characteristics of convulsion and convulsive brain injury.Results A total of 120 children were enrolled,of which 81 developed to BICE and 39 developed to FC during hospitalization.The serum zinc level of children in the FC group was significantly lower than that in the BICE group(μmol/L:39.24±6.50 vs.48.65±7.21,P<0.01).In the BICE group and FC group,the serum zinc level in children with more than 2 convulsions was significantly lower than that in the children with one convulsion(μmol/L:37.65±6.50 vs.53.17±7.55 in the BICE group,and 30.27±5.58 vs.44.16±7.57 in the FC group,both P<0.01).Serum zinc level in children with convulsion duration≥5 minutes was significantly lower than that in the children with convulsion duration<5 minutes(μmol/L:38.75±6.74 vs.51.21±7.58 in the BICE group,and 31.08±5.46 vs.45.19±7.25 in the FC group,both P<0.01).Moreover,the serum zinc level of children with different convulsion frequency and duration in the FC group was significantly lower than that in the BICE group(all P<0.01).Among the 120 children,9 cases of convulsive brain injury occurred,and the incidence rate was 7.50%.The incidence of convulsive bra

关 键 词：轻度胃肠炎伴婴幼儿良性惊厥 热性惊厥 血清锌 惊厥性脑损伤 相关性 

分 类 号：R725.7[医药卫生—儿科]