小儿癫癎持续状态危险因素的病例-对照研究

目的　分析小儿癫持续状态 (SE)的危险因素。方法　对 77例发生SE的住院患儿和1 54例未发生SE的癫患儿进行病例 对照研究 ,采用多元Logistic回归模型分析病因、发作类型等 2 4个因素与SE的关系。结果　单因素分析显示SE的危险因素包括 :有明确病因、既往SE史、癫控制不良、复杂部分性发作、部分继发全身性发作、不典型失神发作、头颅CT和 (或 )MRI弥漫异常、脑电图背景活动异常、局灶性放电和用药依从性差 ;多因素分析显示 :有明确病因 (OR =5 62 )、既往SE史(OR =4 50 )、复杂部分性发作 (OR =2 96)、部分继发全身性发作 (OR =2 40 )、脑电图背景活动异常(OR =2 0 6)、用药依从性差 (OR =1 72 ) 6项OR值的差异有显著性 ,显示其为SE的独立危险因素。结论　有明确病因、既往SE史、复杂部分性或部分继发全身性发作、脑电图背景活动异常、用药依从性差为SE的危险因素 ,可增加小儿SE发生的危险性

A case-controlled study of the risk factors for status epilepticus in children

Objective Status epilepticus (SE) is one of the most common emergencies in pediatric neurology and it is associated with high morbidity and mortality. SE is more frequent in children than in adults. However, little is known about the risk factors for SE in children. The purpose of this study was to determine the risk factors for SE in children. Methods Between January 1, 1995 and June 1, 2000, a case controlled study was conducted in 77 patients (49 males and 28 females) with SE and 154 controls (81 males and 73 females) with epilepsy but without SE Patients and controls did not differ in age at epileptic onset Logistic regression was used in the study Twenty four variables, such as definite etiologies, seizure types, EEG features, etc were analyzed Results Ten factors were related to SE according to a single factor analysis, including definite etiologic factors, previous history of SE, previous history of retractable seizures, complex partial or partial seizures with secondary generalization or atypical absence, abnormal neurological image, abnormal background or focal spike in EEG and poor compliance with antiepileptic drugs With multiple logistic regression analysis, six factors were selected as independent predictors of SE risk: definite etiologic factors( OR =5 62, 95% CI: 3 68-8 14), previous history of SE( OR =4 50, 95% CI : 3 46-5 26), complex partial seizures( OR =2 96, 95% CI : 2 13-4 20), partial seizures with secondary generalization( OR =2 40, 95% CI : 2 16-2 89), abnormal background in EEG( OR =2 06, 95% CI : 1 08-4 10) and poor compliance with antiepileptic drugs( OR =1 72, 95% CI : 1 05-2 33) Conclusion In children, SE is affected by six risk factors: definite etiology, previous history of SE, complex partial seizures, partial seizures with secondary generalization, abnormal EEG background and poor compliance with antiepileptic drugs