儿童病毒感染与热性惊厥相关研究进展

Advances in viral infections and febrile seizures in children

热性惊厥是儿童惊厥最常见的原因, 目前认为热性惊厥的发病机制涉及多种因素, 国内外相关研究多关注遗传易感性, 而环境因素的作用, 尤其病毒感染则是被相对忽视的领域。儿童是各种病毒感染的高发人群, 很多病毒的感染易致高热, 当超过个体惊厥体温阈值时, 可诱发热性惊厥;此外, 病毒感染引发机体生成的炎症细胞因子, 通过血脑屏障影响神经细胞, 促使惊厥的发生。该文综述了儿童多种病毒感染所致热性惊厥的临床特点及发生机制, 如人疱疹病毒-6型、呼吸道病毒(流感病毒、呼吸道合胞病毒、腺病毒、新型冠状病毒等)、胃肠炎相关病毒(轮状病毒、诺如病毒等)、肠道病毒等, 以助临床医生了解热性惊厥中不同病毒感染的作用。

Febrile seizures are the most common cause of convulsions in children.It is believed that the pathogenesis of febrile seizures involves a variety of factors,with most domestic and international studies focusing on genetic susceptibility;in contrast,the role of environmental factors,especially viral infections,is a relatively neglected field.Children are at high risk for various viral infections,many of which are prone to cause hyperthermia and induce febrile seizures when the individual convulsive temperature threshold is exceeded;in addition,inflammatory cytokines produced during viral infections may cross the blood-brain barrier affecting nerve cells.Focusing on the clinical characteristics and pathogenesis of febrile seizures caused by various viral infections in children,such as human herpesvirus-6,respiratory viruses(influenza virus,respiratory syncytial virus,adenovirus,severe acute respiratory syndrome coronavirus 2),gastroenteritis-associated viruses(rotavirus,norovirus),enteroviruses,this review may help clinicians understand the role of different viral infections in febrile seizures.