脑电图对小儿手足口病合并脑炎的诊断及预后价值分析

Analysis on the value of diagnosis and prognosis of electroencephalogram for infantile hand-foot-and-mouth disease combined with encephalitis

目的探讨脑电图对小儿手足口病合并脑炎的诊断及预后价值。方法回顾性分析2013年3月~2015年3月徐州儿童医院收治的手足口病合并脑炎患儿98例的临床资料,所有患儿均于入院后行脑电图检查,并于2周后复查。结果入院后,全部98例患儿均行脑电图检查,结果显示81例异常,异常率为82.65%,临床主要表现为弥漫性慢波活动增多,其中,脑电图轻度异常42例,中度异常26例,重度异常13例。81例患儿均随诊。42例脑电图轻度异常患儿复查后38例脑电图恢复正常,余4例脑电图呈现明显好转趋势;临床随诊结果显示,38例临床症状消失,4例临床症状较前明显好转。26例脑电图中度异常患儿复查后19例脑电图恢复正常,4例脑电图转为轻度异常,3例脑电图持续异常改变;临床随诊结果显示,22例临床症状消失,2例临床症状较前好转,2例临床症状较前无明显改善。13例脑电图重度异常患儿复查后3例脑电图恢复正常,6例脑电图转为中度异常,4例脑电图无明显变化;临床随诊结果显示,3例临床症状消失,7例临床症状较前明显好转,3例临床症状较前无明显改善。Spearman相关分析结果显示,脑电图异常程度随着患儿脑炎程度的增加而增加,且呈正相关,差异有高度统计学意义（r=0.584,P〈0.01）。结论脑电图可作为小儿手足口病并发脑炎的一项有效的诊断标准,有助于判断小儿手足口病并发脑炎的病情严重程度,同时有利于判断疾病的预后。

Objective To investigate the value of diagnosis and prognosis of electroencephalogram for infantile handfoot-and-mouth disease combined with encephalitis. Methods The clinical data of 98 cases with infantile hand-footand-mouth disease combined with encephalitis admitted to Xuzhou Children Hospital from March 2013 to March 2015 was analyzed retrospectively. All children were taken the examination of electroencephalogram after admission and they took reexamination 2 weeks later. Results After admission, all 98 cases of children were taken electroencephalogram,the results showed that there were 81 cases with abnormal electroencephalogram, the abnormal rate was 82.65%, the mainly clinical manifestation was the increase of diffusibility slow wave activities, among whom, there were 42 cases of mild abnormal electroencephalogram, 26 cases of moderately abnormal electroencephalogram, 13 cases of severe abnormal electroencephalogram. All 81 cases were taken subsequent visit. Among 42 cases of mild abnormal electroencephalogram, the electroencephalogram of 38 cases returned to normal, the electroencephalogram of the other 4 cases showed obviously improved trend; clinical follow-up showed that, the clinical symptoms of 38 cases were disappeared,the clinical symptoms of 4 cases were improved markedly. Among 26 cases of moderately abnormal electroencephalogram, the electroencephalogram of 19 cases returned to normal, the electroencephalogram of 4 cases returned to mild abnormal, the electroencephalogram of 3 cases continued to be abnormal; clinical follow-up showed that the clinical symptoms of 22 cases were disappeared, the clinical symptoms of 2 cases were improved markedly, the clinical symptoms of 2 cases were not improved. Among 13 cases of severe abnormal electroencephalogram, the electroencephalogram of 3 cases returned to normal, the electroencephalogram of 6 cases returned to moderately abnormal, the electroencephalogram of 4 cases had no obvious changes; clinical follow-up showed that, the clinical symptoms of 3 cases were disappeared, the clinical symptoms of 7 cases were improved markedly, the clinical symptoms of 3 cases were not improved. Spearman correlation analysis showed that, the abnormal intensity of electroencephalogram was increased with the increase of encephalitis level, and they showed positive correlation with each other, the difference was highly statistically significant（r = 0.584, P 〈 0.01）. Conclusion Electroencephalogram can be taken as an effective standard of diagnosis for infantile hand-foot-and-mouth disease combined with encephalitis, which is helpful to judge the severity of infantile hand-foot-and-mouth disease combined with encephalitis; at the same time, it is helpful to judge the prognosis of disease.