儿童病毒性脑炎急性期临床病理特征对继发癫痫的影响

发布时间：2018-02-28 07:52

  本文关键词： 病毒性脑炎 癫痫 儿童 危险因素 预后　出处：《四川大学学报(医学版)》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨儿童病毒性脑炎急性期临床病理特征对继发癫痫的发生、控制情况和预后的影响。方法纳入2010年1月至2014年1月我院收治的病毒性脑炎患儿,回顾性分析其继发性癫痫控制情况,运用格拉斯哥预后量表评价患儿预后,对急性期临床病理特征(包括临床表现、病毒学、脑电监测、影像学等)资料进行统计分析,采用多因素logistic回归分析病毒性脑炎继发癫痫、癫痫控制差及预后不良的危险因素。结果(1)共纳入506例病毒性脑炎患儿,经1.5年以上随访,继发癫痫58例(11.46%)。(2)Logistic回归分析示急性期反复抽搐发作(标准偏回归系数=3.602)、脑电监测到临床发作(标准偏回归系数=3.061)、癫痫持续状态(标准偏回归系数=2.711)、精神行为性格改变(标准偏回归系数=1.850)为病毒性脑炎患儿继发癫痫的危险因素。(3)继发性癫痫患儿中40例控制好(74.07%),其中37例(92.5%)使用≤2种抗癫痫药物;logistic回归分析未提示病毒性脑炎继发癫痫患儿癫痫控制差的危险因素。(4)格拉斯哥预后量表评分示24例预后不良(41.38%),主要表现为智力运动落后(20例,83.33%)。单因素分析提示急性期癫痫持续状态在继发性癫痫患儿不同预后组间存在差异(P0.05),logistic回归分析未提示病毒性脑炎继发癫痫患儿预后不良的危险因素。结论急性期精神行为性格改变、多次抽搐发作、癫痫持续状态、脑电监测到临床发作是儿童病毒性脑炎继发性癫痫的危险因素,但急性期的临床病理特征与病毒性脑炎继发癫痫临床控制差和临床预后不良无关。
[Abstract]:Objective to investigate the effect of clinical and pathological features of viral encephalitis on the occurrence, control and prognosis of secondary epilepsy in children with viral encephalitis. Methods from January 2010 to January 2014, children with viral encephalitis were treated in our hospital. The control of secondary epilepsy was analyzed retrospectively, the prognosis of children was evaluated by Glasgow prognosis scale, and the clinical and pathological features (including clinical manifestations, virology, EEG monitoring, imaging, etc.) were statistically analyzed. Multivariate logistic regression analysis was used to analyze the risk factors of epilepsy secondary to viral encephalitis, poor control of epilepsy and poor prognosis. Results: a total of 506 children with viral encephalitis were followed up for more than 1.5 years. Logistic regression analysis of 58 cases of secondary epilepsy showed recurrent seizures in acute phase (standard partial regression coefficient 3.602), EEG monitoring of clinical seizures (standard partial regression coefficient 3.061), epileptic status (standard partial regression coefficient 2.711, mental behavior personality change). The risk factor of secondary epilepsy in children with viral encephalitis was 1.850 (standard partial regression coefficient: 1.850). In 40 children with secondary epilepsy, 74.07G was well controlled, and 37 patients were treated with 92.5g). Logistic regression analysis with 鈮，

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