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目的探讨热性惊厥(FC)继发癫癎(EP)的危险因素,以便早期干预.方法对1988年1月至2000年6月在内蒙古医学院第四附属医院儿科住院的253例FC患儿,进行5年至17年5个月随访观察.以第1次FC发作住院为随访起点,再次住院或家庭访问为随访方式,观察FC患儿继发EP的年发生率.并对FC患儿的发作持续时间、发作总次数、发作体温、首次发作24h内的发作次数、初发年龄、惊厥家族史、发作形式、首次发作48h内的脑电图、性别、原发病等可能继发EP的危险因素详细观察记录.所得资料应用生存分析寿命表和生存分析+COX回归作多元回归分析.结果随访253例FC继发EP 19例.5,10,17年继发EP年发生率分别是0.53%,1.69%,8.70%.FC发作持续时间和发作总次数,经分析分别P<0.05和P<0.01,B分别为负值和正值,分别RR<1和RR>1,其95%可信区间内均不包含1;发作形式和惊厥家族史,均P<0.01,B均为正值,均RR>1,其95%可信区间内均不包含1.结论 FC的发作持续时间长、发作总次数增多、局灶性发作及有惊厥家族史是继发EP的危险因素.

Analysis of risk factors of epilepsy after febrile convulsion

Objective To explore the risk factors of epilepsy (EP) after children's febrile convulsion (FC) and to early interfere it.Methods Adopt survival analysis life span table and survival analysis and COX regression to implement 5 years to 17 years and 5 months followed-up for clinical data in 253 FC patient children who were in our hospital from January 1988 to June 2000;take the first FC onset as starting point for following up;take hospitalization again or family visit as way of following up;observe annual incidence of epilepsy after febrile convulsion;collect the following data: duration,the grand total,temperature,frequency in 24 hours for the first FC onset,primary age,convulsion family history,form,EEG in 48 hours for the first FC onset,sex,primary disease of seizures,etc.Results 19 of 253 FC cases were secondary EP.The 5th,10th and 17th annual incidence was 0.53%,1.69%,8.70% respectively. After analysis was completed,FC duration and the grand total respectively were P <0.05 and P <0.01,B was respectively negative and positive,RR<1 and RR>1,and 95% confidence interval excluded 1 in both.For both FC seizures form and convulsion family history, P <0.01,B was positive,RR>1,and 95% confidence interval excluded 1.Conclusion Risk factors for secondary EP are as follows:long duration of seizures,more frequencies of the grand total,focal seizures and family convulsion history.