轻度胃肠炎伴婴幼儿良性惊厥的临床特点分析

Analysis of clinical characteristics of benign infantile convulsions associated with mild gastroenteritis

目的总结分析轻度胃肠炎伴婴幼儿良性惊厥(BICE)的临床特点。方法选取2018年10月~2019年10月沈阳市儿童医院收治的56例BICE患儿作为研究对象,对发病年龄、惊厥临床表现、实验室化验检查结果以及预后随访情况进行回顾性分析。结果56例BICE患儿均为急性起病,75.00%年龄处于1~2岁,62.50%首次惊厥发作时间为发病1~3 d,66.07%惊厥持续时间<3 min,76.78%1个病程中抽搐次数为1~2次;不同年龄段、首次发病惊厥时间、惊厥持续时间、1次发病中的抽搐次数各组间比较,差异有统计学意义(P<0.05)。完善粪便检查病例中轮状病毒阳性占比54.35%,完善视频脑电图病例中,仅有5例出现轻微异常,其余均为正常。67.86%患儿肌酸激酶同工酶(CK-MB)升高,在31例完善微量元素患儿中54.84%血钙水平有所下降。患儿预后良好,出院随访过程中未再出现惊厥发作,异常脑电图复查均恢复正常。结论BICE为婴幼儿时期常见良性惊厥,1次病程中抽搐次数多为1~2次,惊厥持续时间短,预后良好。BICE发病机制可能与轮状病毒感染有关,大部分患儿出现心肌损害以及部分存在血钙水平下降,治疗期间需积极针对性治疗,减少惊厥发作。

Objective To summarize and investigate the clinical characteristics of benign infantile convulsions associated with mild gastroenteritis.Methods A total of 56 patients with BICE admitted to Children′s Hospital of Shenyang from October 2018 to October 2019 as the research objects,the clinical data of age of onset,clinical features of convulsions,results of laboratory examination,prognosis and follow-up were collected and retrospectively analyzed.Results A total of 56 cases of BICE,all cases were acute onset,75.00%were children aged 1-2years,the first attack of convulsion in 62.50%of cases occurred on the 1st to the 3rd day of the disease,the duration of convulsion in 66.07%of cases was less than 3 minutes and the times of convulsion occurred in 76.78%of cases was 1 to 2 times.Comparison among groups of different age,time of first onset convulsion,duration of convulsion and number of convulsations in 1 episode,the differences were statistically significant(P<0.05).The ratio of positive rotavirus antigen in their faeces was 54.35%.Only 5 cases of electroencephalogram(EEG)were mildly abnormal,other cases of EEG were normal.Creatine phosphokinase-MB(CK-MB)of 67.86%cases in BICE increased.The ratio of level of blood calcium decreasing in 31 cases was 54.84%.They all had good prognosis.During the follow-up,no BICE recurred and abnormal EEG returned normal.Conclusion BICE is a common benign infantile convulsion.Convulsion occurs more common for 1 to 2 times,the duration of convulsion is short and prognosis is good.The pathogenesis of BICE may be associated with rotavirus infection.Myocardial damage in most of cases and hypocalcemia in some cases are found.Active targeted treatment is needed to prevent convulsion.