学龄前期脑瘫合并癫痫患儿智能发育的影响因素分析

Analysis of influencing factors of mental development in preschool children with cerebral palsy complicated with epilepsy

目的分析研究学龄前期脑瘫合并癫痫患儿智能发育的影响因素。方法选取2018年10月-2020年10月在新疆医科大学第一附属医院儿科收治的110例3~6岁脑瘫合并癫痫患儿为研究对象,采用Gesell发育量表进行评估,智能发育低下为74例(67.3%),按智能低下严重程度分组,其中轻度21例(28.4%)、中度11例(14.9%)、重度12例(16.2%)、极重度30例(40.5%),对其适应性、大运动、精细运动、语言及个人-社交能区分别进行评估,采用单因素、多因素Logistic回归分析学龄前期脑瘫合并癫痫患儿的智能发育低下的影响因素。结果智能发育低下的学龄前期脑瘫合并癫痫患儿的大运动、精细运动、语言、个人-社交能区在各组间差异有统计学意义(P<0.05)。单因素分析显示,与智能发育正常组比较,智能发育低下组患儿在癫痫首次发作年龄、发作频率、发作类型、脑电图情况、癫痫控制情况差异有统计学意义(P<0.05),在性别、年龄、家族史、脑MRI情况差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,癫痫首次发作年龄<3岁、发作频率≥3次/月、发作类型全面性发作、有家族史、脑电图异常、控制无效是学龄前期脑瘫合并癫痫患儿智能发育低下的影响因素(P<0.05)。结论学龄前期脑瘫合并癫痫患儿智能发育评分较低,癫痫首次发作年龄<3岁、发作频率≥3次/月、发作类型全面性发作、脑电图异常、控制无效是学龄前期脑瘫合并癫痫患儿智能发育低下的影响因素。

Objective To analyze influencing factors of intellectual development in preschool children with cerebral palsy and epilepsy.Methods A total of 110 children with cerebral palsy and epilepsy aged 3-6 years admitted to Department of Pediatrics of the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2020 were selected as study subjects.Gesell Developmental Scale was used for assessment.Seventy-four patients(67.3%)were classified according to the severity of mental retardation,including 21 patients(28.4%)with mild mental retardation,11 patients(14.9%)with moderate mental retardation,12 patients(16.2%)with severe mental retardation,and 30 patients(40.5%)with extreme mental retardation.Adaptability,general motor,fine motor,language,and personal-social function were evaluated respectively.Influencing factors of mental retardation in the preschool children with cerebral palsy and epilepsy were analyzed by univariate and multivariate Logistic regression analysis.Results There were statistically significant differences in gross motor,fine motor,language and personal-social function of children with cerebral palsy and epilepsy in preschool age with low intelligence development(P<0.05).Univariate analysis showed that differences in age,frequency,type,EEG and epileptic control of the first seizure in children with mental retardation group were statistically significant compared with the normal group(P<0.05).However,there were no significant differences in gender,age,family history and brain MRI between the groups(P>0.05).Multivariate logistic regression analysis showed that the age of first attack less than 3 years old,seizure frequency more than 3 times per month,type of seizure,and abnormal EEG ineffective control were influencing factors of low intelligence development in preschool children with cerebral palsy and epilepsy(P<0.05).Conclusion Preschool children with cerebral palsy and epilepsy had lower intelligence developmental quotients.The age of first attack less than 3 years old,seizure frequency more than 3 times per month,type of seizure,abnormal EEG and ineffective control were the influencing factors of low intelligence development in the preschool children with cerebral palsy and epilepsy.