不同年龄段儿童动态脑电图痫样放电阳性率的变化规律研究  

Study on the change rule of positive rate of epileptiform discharge in dynamic electroencephalogram of children of different age groups

作　　者：郑华燕[1] 伍晓蕾 戴芬 ZHENG Hua-yan;WU Xiao-lei;DAI Fen(Electroencephalogram Room,Jiangshan People's Hospital,Jiangshan Branch Hospital of Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University,Jiangshan,Zhejiang 324100,China)

机构地区：[1]江山市人民医院(浙江大学医学院附属邵逸夫医院江山分院)脑电图室,浙江江山324100

出　　处：《中国妇幼保健》2024年第15期2834-2838,共5页Maternal and Child Health Care of China

基　　金：浙江省医学会临床医学科研专项资金项目(2022ZYC-B25)。

摘　　要：目的 探讨不同年龄段儿童24 h动态脑电图痫样放电阳性率变化规律。方法 选取2021年6月-2023年6月江山市人民医院小儿神经内科收治的100例癫痫患儿,按照年龄分为<1岁组、1~3岁组、4~6岁组、7~12岁组、13~18岁组,每组20例患儿。采用动态脑电图仪监测患儿24 h动态脑电图变化。记录各组患儿脑电图分级;观察各组患儿动态脑电图监测下棘波、尖波棘慢复合波、尖慢复合波、多棘慢复合波、爆发性高波幅的痫样放电结果,计算痫样放电阳性率;统计各组患儿痫样放电发作频率;分析各组患儿清醒期、睡眠期、发作期痫样放电检出情况;监测各组患儿睡眠期每分钟痫样放电指数。结果 各组患儿轻度、中度、重度、正常脑电图分级情况比较差异均无统计学意义(均P>0.05)。各组患儿痫样放电总发生率比较差异有统计学意义(P<0.05),爆发性高波幅及痫样放电总发生率以13~18岁组最低。<1岁组、1~3岁组、4~6岁组、7~12岁组、13~18岁组患儿≥1次/月痫样放电发作频率分别为25.00%、55.00%、40.00%、65.00%、20.00%,13~18岁组患儿痫样放电发作频率明显降低(P<0.05)。各组患儿睡眠期痫样放电检出率最高(均P<0.05)。各组患儿非快速眼动睡眠(NREM)期中S1、S2期痫样放电指数明显高于S3、S4、快速眼动睡眠(REM)期。结论 痫样放电阳性率以13~18岁组最低,痫样放电发作频率随着年龄增加而减少,各组患儿睡眠期痫样放电检出率均高于清醒期,且NREM睡眠中S1、S2期高于S3、S4及REM期。Objective To explore the change rule of positive rate of epileptiform discharge in 24-hour dynamic electroencephalogram of children of different age groups.Methods From June 2021 to June 2023,100 children with epilepsy treated in Pediatric Neurology Depart-ment of Jiangshan People's Hospital were selected and divided into<1-year-old group,1-3-year-old group,4-6-year-old group,7-12-year-old group,and 13-18-year-old group according to age,20 cases in each group.Ambulatory electroencephalograph was used to detect the changes of 24-hour dynamic electroencephalogram.Electroencephalogram grades were recorded,the results of epileptiform dis-charge of spike wave,sharp wave,spike and slow wave complex,sharp and slow complex wave,multiple spike and slow complex wave,and explosive high anplitude wave were observed,the positive rate of epileptiform discharge was calculated.The frequencies of epileptiform dis-charge were analyzed.The detection of epileptiform discharge during waking,sleeping.and seizure periods were analyzed.The epileptiform wave discharge index per minute during sleep was monitored.Results There was no statistically significant difference in mild,moderate,severe,and normal EEG grading among 5 groups(P>0.05).There was statistically significant difference in the total incidence rate of epi-leptiform discharge among 5 groups(P<0.05),explosive high amplitude wave and the total incidence rate of epileptiform discharge were the lowest in 13-18-year-old group.The proportions of frequency of epileptiform discharge equal or more than once a month in<1-year-old group,1-3-year-old group,4-6-year-old group.7-12-year-old group,and 13-18-year-old group were 25.00%,55.00%,40.00%,65.00%,and 20.00%,respectively.The frequency of epileptiform discharge in 13-18-year-old group decreased significantly(P<0.05).The detection rate of epileptiform discharge during sleeping was the highest(P<0.05).The epileptiform wave discharge indexes in S1 phase and S2 phase of non-rapid-eye-movement sleep(NREM)were significantly higher than those

关 键 词：儿童 癫痫 动态脑电图 痫样放电阳性率 

分 类 号：R742.1[医药卫生—神经病学与精神病学]