急性期病毒性脑炎患儿临床特点及对继发癫痫的影响

Clinical features of viral encephalitis children in acute stage and its influences on secondary epilepsy

目的探讨急性期病毒性脑炎(VE)患儿临床特点,并分析影响继发癫痫(SEP)的相关因素。方法收集2014-06—2017-06就诊于郑州大学附属儿童医院的76例急性期VE患儿的临床资料,对患儿临床特点进行统计分析,采用Logistic回归模型分析影响急性期VE后SEP的危险因素。结果76例患儿中21例出现SEP,发生率为27.6%。单因素分析显示,VE后SEP组急性发作时出现癫痫持续状态、发作次数>10次的比例均明显高于非SEP组(P<0.05),急性期后继续服用抗癫痫药物(AEDs)比例明显低于非SEP组(P<0.05)。多因素Logistic回归分析显示,急性期出现癫痫持续状态(OR=1.570)、发作次数>10次(OR=1.988)是VE后发生SEP的危险因素(P<0.05),急性期后使用AEDs(OR=0.725)是VE后发生SEP的保护因素(P<0.05)。结论VE患儿SEP发生率较高,癫痫持续状态、发作次数>10次是SEP发生的独立危险因素,建议急性期继续予以AEDs以预防SEP发生。

Objective To explore clinical features of children with viral encephalitis(VE)in acute stage,and to analyze related factors influences secondary epilepsy(SEP).Methods 76 VE children in acute stage who were treated in the hospital from June 2014 to June 2017 were enrolled.The clinical features of children were statistically analyzed.Logistic regression model was applied to analyze risk factors of SEP after acute VE.Results Of 76 patients,there were 21 with SEP,with incidence of 27.6%.Univariate analysis showed that proportion of persistent epilepsy status and attack number more than 10 times in SEP group were significantly higher than that in non-SEP group after VE in acute stage(P<0.05),while proportion of antiepileptic drugs(AEDs)continuous usage was significantly lower than that in non-SEP group(P<0.05).Multivariate Logistic regression analysis showed that persistent epilepsy status(OR=1.570)and attack number more than 10 times(OR=1.988)in acute stage were risk factors of SEP after VE(P<0.05),while AEDs(OR=0.725)usage was a protective factor(P<0.05).Conclusion The incidence of SEP is higher in VE children.The persistent epilepsy status and attack number more than 10 times are risk factors of SEP.It is recommended to continue AEDs usage in acute stage to prevent SEP.