不同时长抗癫痫药物治疗急性脑炎综合征儿童急性症状性癫痫发作的效果比较  

Comparison of the effectiveness of different durations of anti-seizure medication in managing acute symptomatic seizures in children with acute encephalitis syndrome

作　　者：吴芳 窦香君 齐红艳 Wu Fang;Dou Xiangjun;Qi Hongyan(Department of Neurology,Xi'an Children's Hospital,Xi'an 710003,Shaanxi Province,China)

机构地区：[1]西安市儿童医院神经内科,西安710002

出　　处：《中国基层医药》2024年第9期1295-1299,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：“新锐酮学”研究项目基金(CX-2022-004)。

摘　　要：目的比较应用不同时长的抗癫痫药物(ASM)治疗急性脑炎综合征(AES)患儿急性症状性癫痫发作的效果。方法回顾性选取2020年5月至2022年5月西安市儿童医院神经内科收治的急性症状性癫痫发作的AES患儿186例。两组均接受ASM治疗,按照治疗时长的不同分为观察组(治疗4周)93例和对照组(治疗12周)93例。比较两组患儿脑电图异常率、治疗有效率及癫痫发作复发率,同时根据复发结果将患儿分成复发组和未复发组,收集并比较两组临床资料,分析癫痫发作复发影响因素。结果观察组脑电图异常率、治疗有效率及癫痫发作复发率与对照组比较,差异均无统计学意义(χ^(2)=1.90、0.98、0.36,均P>0.05)。186例患儿随访1年的癫痫发作复发12例,未复发174例,单因素分析显示,复发组在意识状态、脑电图、儿童大脑表现类别量表(PCPC)评分方面与未复发组比较差异均有统计学意义(χ^(2)=6.16、4.40、5.88,均P<0.05)。二元logistic回归的进一步分析显示,意识状态(重度昏迷)、PCPC评分3~4分是AES患儿癫痫发作复发的独立危险因素(均P<0.05)。结论4周与12周ASM治疗AES患儿急性症状性癫痫发作效果相当。重度昏迷、PCPC评分3~4分与急性症状性癫痫发作复发显著相关,临床应予以重视。Objective To compare the effectiveness of different durations of anti-seizure medications for acute symptomatic seizures in children with acute encephalitis syndrome.Methods A total of 186 children with acute symptomatic seizures who received treatment at the Department of Neurology,Xi'an Children's Hospital,from May 2020 to May 2022 were retrospectively included in this study.All patients were treated with anti-seizure medications.These children were divided into an observation group(n=93,4-week anti-seizure medication)and a control group(n=93,12-week anti-seizure medication)according to different durations of anti-seizure medication they received.The abnormal rates of electroencephalogram findings,treatment effectiveness,and recurrence rates of epileptic seizures were compared between the two groups.These children were divided into a recurrent group and a non-recurrent group based on their seizure recurrence outcomes.Clinical data from both groups were collected and compared.The factors influencing the recurrence of epileptic seizures were analyzed.Results There were no significant differences in abnormal rates of electroencephalogram findings,treatment effectiveness,and recurrence rates of epileptic seizures between the observation and control groups(χ^(2)=1.90,0.98,0.36,all P>0.05).Among the 186 children who were followed up for 1 year,epileptic seizures recurred in 12 cases,while 174 cases did not experience any recurrence.Univariate analysis revealed statistically significant differences between the recurrent and non-recurrent groups in terms of consciousness status,electroencephalogram findings,and Pediatric Cerebral Performance Category scores(χ^(2)=6.16,4.40,5.88,all P<0.05).Further analysis using binary logistic regression identified severe coma and Pediatric Cerebral Performance Category scores of 3-4 as independent risk factors for recurrent seizures in children with acute symptomatic seizures(both P<0.05).Conclusion Four-week and twelve-week anti-seizure medication for acute symptomatic seizure in

关 键 词：脑炎 综合征 癫痫 治疗结果 复发 影响因素分析 

分 类 号：R742.1[医药卫生—神经病学与精神病学]