幼儿急疹合并热性惊厥的临床特征

Clinical characteristics of roseola infantum with febrile convulsions

目的探讨幼儿急疹合并热性惊厥的临床特征。方法回顾性总结本院2005年1月至2008年2月确诊的幼儿急疹病例和热性惊厥病例，对幼儿急疹并热性惊厥的31例患儿的临床资料进行总结，与其他热性惊厥患儿及幼儿急疹未合并热性惊厥者对比，并结合文献进行分析。结果幼儿急疹合并热性惊厥患儿占所有热性惊厥的17.1％（31／181），占2岁内热性惊厥的24.4％（31/127），占幼儿急疹患儿的15.7％（31／198）；幼儿急疹并热性惊厥患儿出现热性惊厥的平均年龄为（0.85±0.38）岁，早于一般的热性惊厥患儿（2.41±1.30）岁，P〈0.01；与不伴热性惊厥的幼儿急疹患儿比较，伴热性惊厥者的性别、年龄、最高体温、热程、出疹时问均无显著差别（P〉0.05），而热性惊厥家族史有显著差别（P〈0.05）。结论遗传因素是导致幼儿急疹并热性惊厥发作的一个危险因素；幼儿急疹并热性惊厥时一般预后良好，但要警惕发生严重中枢神经系统损伤的可能性，如癫痫。对于1岁内初次发热并出现热性惊厥的息儿要注意幼儿急疹的可能。

Objective To explore the clinical characteristics of roseola infantum with febrile convulsions. Methods All cases with roseola infantum or with febrile convulsions were retrospectively collected who were confirmed during January 2005 to February 2008. There were 31 cases of roseola infantum with febrile convulsions. Their clinical features were compared with cases of roseola infantum without febrile convulsions and cases of other febrile convulsions, respectively, and further analyzed with literature. Results There were 17.1% （31/181） roseola infantum with febrile convulsions among febrile convulsions and 24.4 % （31/127） among febrile convulsions less than 2 years;The incidence of roseola infantum with febrile convulsions was 15.7% （31/198） among roseola infantum. The median age of roseola infantum with febrile convulsions was less than that of other febrile convulsions. There were no significant differences in sex, age, maximum body temperature, duration of fever and day of rash onset between roseola infantum with and without febrile convulsions （ P 〉 0.05）, but the frequency of family history of febrile convulsions was significantly higher in roseola infantum with febrile convulsions than in those without febrile convulsions （ P 〈 0.05）. Conclusions Familial predisposition is a risk factor in roseola infantum with febrile convulsions. In most cases the prognosis of roseola infantum with febrile comntlsions was good, but it can be associated with severe diseases of central nervous system. Roseola infantum should be considered when encountering children under the age of 1 year with a first febrile convulsion.