热性惊厥首发的相关危险因素研究

Assessment on risk factors associated with first episode of febrile seizure

目的探讨热性惊厥(febrile seizures,FS)首发的相关危险因素。方法选择2011年8月至2016年8月本院收治的首发FS患儿484例作为FS组,同期同数量发热患儿作为对照组,收集两组相关临床资料进行对比研究。结果 71.9%的FS患儿首次惊厥发生年龄为6~36个月,其中42.8%集中于12~18个月;男女比为1.75:1。与对照组相比,FS患儿的平均最高温度明显增高,有FS家族史的比例更高。FS组血红蛋白、平均红细胞体积、平均血红蛋白量、血钠、血钙、血糖水平明显低于对照组。64例FS患儿惊厥发生前2周内接种过疫苗,且多于3~10天内接种。FS与对照组患儿在母亲产时年龄和妊娠并发症方面差异无显著性,但在产时并发症上FS组有72例(14.9%),对照组仅38例(7.9%),差异有显著性(P<0.001)。FS组与对照组患儿早产分别为82和53例,出生体重分别为(3167±1317)g和(3324±965)g,差异有显著性(P<0.05)。结论年龄、性别、FS家族史、高峰温度、低血钠、低血钙、小细胞低色素贫血、产时并发症(出血、难产)以及特定疫苗接种是FS首发的危险因素,临床上可采取相应措施以减少FS的发生。

Objective To evaluate the risk factors associated with the first episode of FS. Method Data were obtained from the 484 children with first episode FS and the same number children with fever but without seizure in Chengdu Women and Children Central Hospital from August, 2011 to August, 2016. Result 71.9% of children with FS were noted in 6 to 36 months age, 42.8% of whom aged between 12 to 18 months. Male： female ratio was 1.75：1. As compared with the controls, the mean peak temperature is higher and the number of children with positive family history was much more. The mean HGB, MCV, MCH, serum sodium, serum calcium and random blood sugar values of the cases were significantly lower than those of controls. FS occurred within two weeks of vaccine administration in 64 patients, the majority were in 3 to 10 days. No significant difference between FS and Controls on mothers＇ age and pregnancy complications. However, there was 72 seizure patients whose mother with intrapartum complications compared with just 38 in controls（P〈0.001）. Furthermore, 82 preterm births were found in FS while 53 preterm births in controls（P〈0.01）. And the mean birth weight in FS was（3167±1317）g, compared with（3324±965）g in controls（P〈0.05）. Conclusion The age, male gender, positive family history, peak temperature, microcytic hypochromic anemia, low serum calcium, sodium, blood sugar, perinatal complications and vaccination are the risk factors associated with the first episode FS. Therefore, it is important to take preventive measures in removing these risk factors for decreasing the incidence of FS.