反复发作热性惊厥患儿海马体积动态变化的临床研究

Dynamic change of hippocampal volume in children with recurrent febrile seizures

摘要:

目的 分析反复发作热性惊厥患儿海马体积（HCV）的变化及意义。方法 回顾性选择34例热性惊厥反复发作且于2013年1月1日至2019年9月30日期间完善2次头部及海马磁共振平扫患儿的临床资料和检查结果。根据随访时间，分为第1次随访组和第2次随访组；根据预后，分为热性惊厥组、无热惊厥组和癫痫组。分析比较各组患儿HCV变化情况。结果 34例患儿总HCV与年龄呈正相关（r_s=0.683，P < 0.05）。第2次随访组总HCV大于第1次随访组（P < 0.05），两组学龄前患儿（年龄≥3岁）总HCV、左侧HCV、右侧HCV均大于婴幼儿患儿（年龄 < 3岁）（P < 0.05）。两组惊厥持续状态患儿总HCV平均每年增大值（△V）、左侧△V、右侧△V均小于非惊厥持续状态患儿（P < 0.05）。热性惊厥患儿、无热惊厥患儿及癫痫患儿总△V、左侧△V、右侧△V差异无统计学意义（P > 0.05）。结论 反复发作热性惊厥患儿的HCV随年龄增长逐渐增大，惊厥持续状态会损伤海马发育。

Abstract:

Objective To study the change and significance of hippocampal volume(HCV) in children with recurrent febrile seizures. Methods A retrospective analysis was performed on the medical data and examination results of 34 children with recurrent febrile seizures who underwent two magnetic resonance plain scans of the head and the hippocampus from January 1, 2013 to September 30, 2019. According to the follow-up time, they were divided into the first follow-up group and the second follow-up group. According to prognosis, they were divided into a febrile seizure group, a non-febrile group and an epilepsy group. The change in HCV was analyzed and compared. Results Total HCV was positively correlated with age(r_s=0.683, P<0.05). The second follow-up group had a significantly larger total HCV than the first follow-up group(P<0.05). For both groups, preschool children(≥3 years old) had significantly larger total HCV, left HCV, and right HCV than those at an age of <3 years(P<0.05). For both groups, the children with persistent seizures had significantly lower average annual increment(ΔV) of total HCV, left HCV, and right HCV than those without persistent seizures(P<0.05). There was no significant difference in ΔV of total HCV, left HCV, and right HCV among the febrile seizure, non-febrile seizure and epilepsy groups(P>0.05). Conclusions HCV gradually increases with age in children with recurrent febrile seizures. Persistent seizures may damage the development of the hippocampus.