摘要
目的 以MRI+FLAIR评估热性惊厥(FS)患儿脑白质髓鞘发育情况,并探讨与患儿临床特征的相关性,为FS的诊治和远期预后奠定基础。方法 选取内蒙古自治区人民医院2019年1月至2021年12月收治的210例FS患儿为研究对象并完善头颅MRI+FLAIR检查,将有髓鞘化延迟的患儿设为实验组,无髓鞘化延迟的患儿设为对照组,对两组患儿的临床资料进行回顾性分析。结果 (1)符合入组标准的210例FS患儿中,6~12个月龄是惊厥首次发作高发年龄,88例(41.90%),复发病例82例(39.05%),惊厥类型以全身强直发作为主205例(97.62%)。(2)髓鞘化发育延迟与首发年龄、一次热程中发作次数、一次发作持续时间、发作时最高体温、FS家族史有相关性,与对照组比较差异有统计学意义(P<0.05)。(3)线性回归分析示发作持续时间、发作次数、复发情况与髓鞘化延迟呈显著正相关(P<0.05,B>0),即实验组患儿一次惊厥发作的持续时间更长、一次发作以及复发的次数更多;发作时最高体温与髓鞘化延迟呈显著负相关(P<0.05,B<0),即实验组与对照组相比,惊厥发作时的最高体温较低。(4)Logistics回归分析示FS家族史阳性可以显著影响髓鞘化延迟,是髓鞘化延迟的独立危险因素。结论 FS家族史阳性的患儿其髓鞘化延迟的发生率更高。且髓鞘化延迟的FS患儿一次惊厥发作的持续时间更长、一次发作以及复发的次数更多。提示我们对FS患儿尤其是FS家族史阳性的患儿需完善MRI+FLAIR评估髓鞘发育情况,对评估患儿早期病情以及预防复发等方面有重要指导意义。
Objective To investigate the development of myelin in the brain of children assessed by MRI+FLAIR and to analyse its correlation with the clinical features of children with febrile seizures(FS),in order to lay the foundation for the diagnosis and treatment of FS and its long-term prognosis.Methods From January 2019 to December 2021,210 children dignosis with febrile seizures in our department were selected and divided into experimental group and control group according to according to MRI+FLAIR results.Clinical data of two groups of children were analyzed retrospectively.Results(1)Among the 210 FS children,88 cases(41.90%)had their first seizures in 6-12 months,82 cases(39.05%)had recurrent seizures,and 205 cases(97.62%)had generalized tonic seizures.(2)The delayed development of myelination was correlated with the age of first episode,the number of seizures in one febrile course,the duration of one attack,the highest body temperature at onset and the FS family history.There was significant difference compared with the control group(P<0.05).(3)In the experimental group,the duration of a convulsion was longer,the number of seizures and relapses were more(P<0.05,B>0),and the highest body temperature of the experimental group was lower than that of the control group(P<0.05,B<0).(4)FS family history can significantly affect delayed myelination,which is an independent risk factor for delayed myelination.Conclusion Children with a family history of FS have a higher incidence of delayed myelination.The FS children with delayed myelination had a longer duration of convulsion,more times of recurrence and seizures.It is suggested that it is necessary to improve MRI to evaluate myelin development in children with FS,especially those with family history of FS,which has important guiding significance in evaluating children's early condition and preventing recurrence.
作者
汪芷羽
苏学文
WANG Zhiyu;SU Xuewen(Baotou Medical College,Baotou 014000 China;Department of Pediatrics,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 010017 China)
出处
《内蒙古医学杂志》
2023年第5期558-562,共5页
Inner Mongolia Medical Journal
基金
内蒙古自治区自然科学基金(编号:2018MS08067)。
关键词
热性惊厥
髓鞘发育
儿童
febrile seizures
myelin sheath development
children
