儿童惊厥性癫痫持续状态的病因及其预后的影响因素

目的 探讨儿童惊厥性癫痫持续状态的病因及其预后的影响因素.方法 收集103例惊厥性癫痫持续状态患儿的临床资料,总结其病因,分析影响患儿预后的影响因素.结果 103例惊厥性癫痫持续状态患儿中,最常见的病因为热性惊厥(34%),其次为急性症状性病因(32%),而66.7%的急性症状性病因为颅内感染(包括化脓性脑膜炎、病毒性脑炎、结核性脑膜炎).20例患儿预后不良(19.4%),在院死亡患儿共6例(5.8%).年龄≤2岁、惊厥持续时间>60 min、C反应蛋白>10 mg/dl及血糖<3.9 mmol/L或>6.1 mmol/L是惊厥性癫痫持续状态患儿预后不良的危险因素(P<0.05).结论 热性惊厥及颅内感染是惊厥性癫痫持续状态患儿常见的病因.可将年龄、惊厥持续时间、C反应蛋白及血糖水平作为作为癫痫持续状态患儿预后的早期预测因子.

Etiology and factors influencing prognosis of children with convulsive status epilepticus

Objective To explore the etiology and factors influencing the prognosis of children with convulsive status epilepticus.Methods Clinical data of 103 children with convulsive status epilepticus were retrospectively analyzed.The etiology was summarized and the factors influencing the prognosis of the children were analyzed.Results Of the 103 children with convulsive status epilepticus,the most common etiology was febrile seizure(34%),and the secondly common etiology was acute symptomatic causes(32%).Intracranial infection(including purulent meningitis,viral encephalitis and tubercular meningitis) accounted for 66.7% of acute symptomatic causes.Poor outcome was found in 20 children(19.4%) and death during hospitalization occurred in 6 children(5.8%).Age ≤2 years,seizure duration >60 minutes,C-reactive protein(CPR) level >10 mg/dl and blood glucose level <3.9 mmol/L or >6.1 mmol/L were the risk factors for poor outcome in children with convulsive status epilepticus(P<0.05).Conclusion Febrile seizure and intracranial infection are the common causes of children with convulsive status epilepticus.Age,seizure duration,CRP and blood glucose levels can be taken as the early predictors of outcomes in children with convulsive status epilepticus.