呼吸道病毒感染与儿童热性惊厥相关性的前瞻性研究

目的探讨热性惊厥(FS)患儿中常见呼吸道病毒感染的相关病毒,评价FS发作中病毒感染的危险因素以及病毒类型。方法选取276例FS患儿(FS组)及90例有发热而无惊厥的上呼吸道感染患儿(对照组),并对所有纳入本研究的患儿在入院后次日清晨行深部鼻咽分泌物采集,采用直接免疫荧光法对其鼻咽部脱落细胞进行呼吸道常见病毒抗原检测。应用SPSS 13.0软件进行统计学分析。结果 FS患儿中,上呼吸道感染最常见(占61.6%);FS分型中,单纯性FS最多见(占63.0%);FS患儿常见呼吸道病毒感染监测中,流感病毒A最多见,占20.3%。FS组上呼吸道感染患儿流感病毒A感染率(30.0%)明显高于对照组(13.3%)。流感病毒A感染的FS患儿较非流感病毒A感染的FS患儿具有月龄更大、惊厥时体温更高、发热到惊厥时间更短等特点(Pa<0.05)。结论流感病毒A是发生FS的相对危险因素,流感病毒A感染多见于≥3岁FS患儿,在流感病毒流行季节对既往有FS病史的大龄儿童(≥3岁)进行流感疫苗接种,减少流感病毒感染发生,是预防FS发作的有效方法。

Prospective Study of Relationship between Respiratory Viral Infections and Febrile Seizures in Children

Objective To explore the viruses associated with febrile seizures(FS) in the common respiratory viral infections and eva-luate the risk factors of the viral infections as well as the related viral types to the development of FS. Methods Two hundred and seventy-six patients with FS(FS group) and 90 upper respiratory infections(URIs) patients with febrile and without seizures(control group) were prospectively surveyed.Secretions from the nasopharyngeal epithelium were aspirated in these hospitalized children on the next morning.Viral antigens were detected by rapid direct fluorescent test in the aspirated epithelia. Results The URIs were the most common disease associated with FS,which accounted for 61.6%;and the simple FS was the most common type,which accounted for 63.0%.The influenza A was the most common virus in the FS children with respiratory viral infections and the incidence of influenza A infection was 20.3%.Among the patients suffered from the URIs,the incidence of influenza A infections was 30.0% in the FS patients,a proportion significantly higher than that in control group(13.3%).When compared with non-influenza A infected FS patients,the patients infected with influenza A had clinical characteristics of an older age,a higher body temperature at seizure occurrence and shorter seizure duration(Pa<0.05). Conclusions Influenza A is a relative risk factor for the development of FS.Influenza A infections are found more in the FS patients aged≥3 years.In the influenza epidemics,the vaccination administered in elder children with a past FS history,may be a effective way to prevent FS.