摘要
目的探讨新生儿惊厥患儿视频脑电图(video electroencephalogram,VEEG)特点及其与临床表现、预后的关系。方法选择2012年1月至2019年7月北京大学第一医院新生儿病房收治的新生儿惊厥患儿进行回顾性研究,根据脑电图表现分为轻、中、重度异常3组,比较各组VEEG特点、病因、临床发作特点及预后差异。结果共纳入162例新生儿惊厥患儿,脑电图轻度异常组41例,中度异常组61例,重度异常组60例。脑电图重度异常组遗传性病因构成比高于非重度异常组(轻度+中度异常组)[38.3%(23/60)比21.6%(22/102)]、颅内出血/脑卒中比例低于非重度异常组[6.7%(4/60)比23.5%(24/102)]、每日均有发作的比例高于非重度异常组[76.7%(46/60)比32.4%(33/102)],差异有统计学意义(P<0.05);重度异常组与非重度异常组患儿起病日龄≤3 d的比例比较差异无统计学意义(P>0.05);脑电图重度异常组新生儿期后发展为癫痫、神经系统发育重度异常比例显著高于脑电图轻度、中度异常组(P均<0.05)。结论脑电图重度异常患儿遗传性病因比例高,惊厥发作更频繁,新生儿期后更易发生神经系统发育异常和(或)发展为癫痫,预后不良。对于脑电图重度异常且病因未明的新生儿惊厥患儿,需积极完善遗传学检查。
Objective To study the video electroencephalogram(VEEG)features,clinical manifestation and prognosis of neonatal seizures.Method From January 2012 to July 2019,a retrospective study was conducted on newborn infants with neonatal seizures admitted to the neonatal ward of our hospital.According to VEEG characteristics,the patients were assigned into mild,moderate and severe abnormal groups.The VEEG characteristics,etiology,seizure frequency and prognosis of each group were compared.Result A total of 162 neonates with neonatal seizures were included,including 41 cases in the mild abnormal group,61 in moderate abnormal group and 60 in severe abnormal group.The incidences of hereditary etiology[38.3%(23/60)vs.21.6%(22/102)]and everyday seizure episode[76.7%(46/60)vs.32.4%(33/102)]in the severe abnormal group were significantly higher than the non-severe abnormal group(mild and moderate abnormal groups)(P<0.05).40 infants in the severe abnormal group had seizure within 3 d after birth and 61 in the non-severe abnormal group and the incidence showed no statistically significant difference between the two groups(P>0.05).The proportion of epilepsy and neurodevelopmental abnormality after neonatal period in the severe abnormal group were significantly higher than the mild and moderate group(P<0.05).Conclusion Newborns with severe abnormal VEEG are more likely to have hereditary etiology,frequent seizures,neurodevelopmental abnormality and/or epilepsy after neonatal period,with poor prognosis.For neonatal seizure patients with severe abnormal EEG and unknown etiology,genetic examination is highly recommended.
作者
马源培
郝佳
杨志仙
孙国玉
汤泽中
侯新琳
刘黎黎
Ma Yuanpei;Hao Jia;Yang Zhixian;Sun Guoyu;Tang Zezhong;Hou Xinlin;Liu Lili(Department of Pediatrics,Peking University First Hospital,Beijing 100034,China)
基金
北京大学临床医学+X青年专项(PKU2020LCXQ010)
首都临床诊疗技术研究及示范应用(Z191100006619049)。
关键词
新生儿惊厥
脑电图
临床表现
预后
Neonatal seizures
Electroencephalogram
Clinical manifestation
Prognosis
