热性惊厥发作患儿3年内继发癫痫的影响因素分析

Influencing factors of secondary epilepsy in children with febrile convulsion within 3 years

目的分析热性惊厥发作患儿3年内继发癫痫的影响因素。方法收集2015年2月至2018年3月山东第一医科大学附属聊城二院收治的110例热性惊厥发作患儿的病历资料。所有患儿均随访3年,按3年内继发癫痫与否分为继发癫痫组与非继发癫痫组。比较两组患儿一般资料、临床资料及感染指标情况,分析热性惊厥发作患儿继发癫痫的影响因素。结果110例患儿中,继发癫痫29例(26.36%),未继发癫痫者81例(73.64%)。继发癫痫患儿中强直-阵挛发作12例,复杂部分发作9例,失神发作3例,继发全身发作5例。继发癫痫组患儿年龄≤2岁者、有癫痫家族史者、脑电图异常者、复杂型惊厥发作者、首次发作24 h内惊厥2次以上者及发作时体温39℃~40℃者占比均多于未继发癫痫组(P均<0.05);继发癫痫组血降钙素原及血肿瘤坏死因子-α水平[(3.06±0.85)μg/L、(862.54±104.72)ng/L]均高于未继发癫痫组[(2.19±0.74)μg/L、(641.35±93.51)ng/L],P均<0.05。多因素回归分析结果显示,年龄、惊厥类型、脑电图结果、血降钙素原水平、癫痫家族史、首次发作24 h内惊厥次数是热性惊厥发作患儿继发癫痫的独立影响因素(P<0.05)。结论年龄≤2岁、有癫痫家族史、脑电图异常、复杂型惊厥、首次发作24 h内惊厥2次以上及血降钙素原水平异常增高均为热性惊厥发作患儿3年内继发癫痫的影响因素。

Objective To analyze the influencing factors of secondary epilepsy in children with febrile convulsion within 3 years.Methods The case data of 110 children with febrile convulsion treated in Liaocheng Second Hospital Affiliated to Shandong First Medical University from February 2015 to March 2018 were collected.All children were followed up for 3 years.They were divided into secondary epilepsy group and non secondary epilepsy group according to occurrence of secondary epilepsy within 3 years.The general data,clinical data and infection indicators of the two groups were compared,and the influencing factors of secondary epilepsy in children with febrile convulsion were analyzed.Results Among 110 patients,29 cases(26.36%)had secondary epilepsy,and 81 cases(73.64%)had non secondary epilepsy.Among the patients with secondary epilepsy,there were 12 cases of tonic clonic seizures,9 cases of complex partial seizures,3 cases of absence seizures and 5 cases of secondary systemic seizures.The proportions of children with age≤2 years,family history of epilepsy,abnormal electroencephalogram(EEG),complicated by complex convulsion,more than two convulsion within 24 hours after the first seizure,and the body temperature at 39℃-40℃in the secondary epilepsy group were more than those in the non secondary epilepsy group(all P<0.05).The levels of procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)in secondary epilepsy group were(3.06±0.85)μg/L and(862.54±104.72)ng/L,respectively,which were higher than the(2.19±0.74)μg/L and(641.35±93.51)ng/L in non-secondary epilepsy group,all P<0.05.Multivariate regression analysis showed that age,convulsion type,EEG results,blood PCT level,family history of epilepsy and the times of convulsion within 24 hours after the first seizure were independent influencing factors of secondary epilepsy in children with febrile convulsion(P<0.05).Conclusions Age≤2 years,family history of epilepsy,abnormal EEG,complex seizure,more than 2 times of convulsion within 24 hours after the first seizure and abnormally increased blood PCT levels are influencing factors of secondary epilepsy within 3 years in children with febrile convulsion.