儿童热性惊厥临床特征及其变化趋势

Changing trends and clinical characteristics of febrile seizures in children

摘要:

目的 探讨热性惊厥(FS)患儿的临床特征及其变化趋势.方法 回顾性总结2004~2013年10年间收治的1 922例FS患儿的临床资料,分析其临床特征及前后5年的变化趋势.结果 1 922例FS患儿中,男女比例为2.27 : 1,平均发病年龄3.0±1.8岁,发病年龄高峰为1~3岁.单纯型1 556例(80.96%),复杂型366例(19.04%).2008~2013年FS患儿1 202例,比2004~2008年(720例)增长了66.9%,且复杂型FS患儿比例升高(21.13% vs 15.56%)(P<0.05).与2004~2008年相比,2009~2013年单纯型FS患儿在惊厥发病年龄、发作时体温、抽搐持续时间及合并症发生率等方面差异均无统计学意义(均P>0.05);而复杂型FS患儿的发病年龄更小,发作时体温更低,抽搐时间更长,且出现心肌损伤、低钠血症等合并症的发生率更高(均P<0.05).结论 10年间FS患儿病例数呈上升趋势,复杂型FS发生率升高,且各临床特征均向不利方向变化,应重视复杂型FS的及时诊断和治疗.

Abstract:

Objective To investigate the clinical characteristics and changing trends of febrile seizures (FS) in children. Methods The clinical data of 1 922 children with FS admitted from 2004 to 2013 were analyzed retrospectively. The clinical characteristics and changing trends of FS in the two five-year periods were analyzed. Results In 1 922 children with FS, the male/female ratio was 2.27:1. The mean age at onset was 3.0±1.8 years, while the peak age at onset was 1-3 years. There were 1 556 children (80.96%) with simple FS and 366 (19.04%) with complex FS. The number of children with FS in the second five-year period (1 202 cases) increased by 66.9% compared with that in the first five-year period (720 cases). The proportion of children with complex FS was significantly higher in the second five-year period than in the first five-year period (21.13% vs 15.56%; P<0.05). In children with simple FS, there were no significant differences in the age and body temperature at onset, convulsion duration, and the incidence of complications between the two five-year periods (P>0.05). However, children with complex FS had a significantly lower age at onset, a significantly lower body temperature at onset, a significantly longer convulsion duration, and a significantly higher incidence of complications including myocardial injury and hyponatremia in the second five-year period than in the first five-year period (P<0.05). Conclusions In the last decade, the number of children with FS and incidence of complex FS increased, and the outcome became worse according to clinical characteristics, suggesting that more attention should be paid to timely diagnosis and treatment of complex FS.