外周血红细胞分布宽度、神经元特异性烯醇化酶水平对高热惊厥患儿预后的预测价值

Prognostic value of the levels of red blood cell distribution width and neuron specific enolase in peripheral blood in children patients with febrile convulsion

目的 探究外周血红细胞分布宽度(RDW)、神经元特异性烯醇化酶(NSE)水平对高热惊厥患儿预后的预测价值。方法 选取江苏省张家港市第三人民医院2018年1月至2022年6月收治的82例高热惊厥患儿。对患儿予12个月的随访,观察患儿预后情况,并根据预后结果将其分为预后良好组与预后不良组。比较两组外周血RDW、NSE水平;比较两组临床资料;分析高热惊厥患儿预后的影响因素,受试者操作特征曲线分析RDW、NSE水平对高热惊厥患儿预后的预测价值。结果 高热惊厥患儿预后不良发生率为25.61%(21/82)。预后不良组RDW、NSE水平高于预后良好组(P<0.05)。预后不良组年龄≤3岁、复杂型高热惊厥、有高热惊厥家族史、惊厥平均持续时间≥15 min、合并贫血、脑电图异常者占比高于预后良好组(P<0.05)。高热惊厥家族史(OR=6.392)、RDW(OR=3.915)、NSE(OR=4.542)是高热惊厥患儿预后的独立危险因素(P<0.05)。RDW、NSE联合预测高热惊厥患儿预后的曲线下面积高于各指标单独预测。结论 外周血RDW、NSE水平是影响高热惊厥患儿预后的独立危险因素,通过检测外周血RDW、NSE水平可有效预测患儿预后,且二者联合预测价值更高。

Objective To explore the prognostic value of the levels of red blood cell distribution width(RDW) and neuron-specific enolase(NSE) in peripheral blood in children patients with febrile convulsion.Methods A total of 82 children patients with febrile convulsion admitted to the Third People's Hospital of Zhangjiagang from January 2018 to June 2022 were selected.The children patients were followed up for 12 months to observe their prognosis.According to the prognosis,they were divided into good prognosis group and poor prognosis group.The levels of RDW and NSE in peripheral blood were compared between two groups;the clinical data of two groups were compared;the factors affecting the prognosis of children patients with febrile convulsion were analyzed;and the predictive value of the levels of RDW and NSE on prognosis of the children patients with febrile convulsion was analyzed by receiver operating characteristic curve.Results The incidence of poor prognosis in children patients with febrile convulsion was 25.61%(21/82).The levels of RDW and NSE in poor prognosis group were higher than those in good prognosis group(P<0.05).The proportion of chidren with age ≤3 years,complex febrile convulsion,family history of febrile convulsion,mean duration of convulsion ≥15 min,anemia,and abnormal electroencephalogram in poor prognosis group were higher than those in good prognosis group(P<0.05).Family history of febrile convulsion(OR=6.392),RDW(OR=3.915),and NSE(OR=4.542) were independent risk factors on prognosis of the children patients with febrile convulsion(P<0.05).The area under the curve of RDW and NSE combined predicted the prognosis of children patients with febrile convulsion was higher than that predicted by each indicator alone.Conclusion The levels of RDW and NSE in peripheral blood are independent risk factors affecting the prognosis of children patients with febrile convulsion.Detection the levels of RDW and NSE in peripheral blood can effectively predict the prognosis of children patients with febrile convulsion,and their combined prediction value is higher.