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目的探讨热性惊厥(FC)继发癫(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EP19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。
Objective To investigate the risk factors of secondary epilepsy (EP) in febrile seizures (FC) for early intervention. Methods From January 1988 to June 2000, 253 cases of FC hospitalized in pediatric department of the Fourth Affiliated Hospital of Inner Mongolia Medical College were followed up for 5 years to 17 years and 5 months. The first episode of FC was hospitalized as the starting point of follow-up, and again hospitalization or family visit was followed up to observe the annual incidence of secondary EP in children with FC. The duration of the attack, the total number of attacks, the onset temperature, the number of seizures in the first episode within 24 hours, the age at onset, the family history of seizures, the type of seizure, the EEG within 48 hours after the first seizure, gender, primary disease Such as possible secondary risk factors EP detailed observation records. The obtained data were analyzed by multivariate regression analysis using survival analysis life-table and survival analysis + COX regression. Results Follow-up 253 cases of FC secondary EP19 cases. The incidence rates of secondary EP in 5, 10 and 17 years were 0.53%, 1.69% and 8.70% respectively. FC episodes duration and the total number of attacks, respectively, P <0.05 and P <0.01, respectively, B were negative and positive, respectively, RR <1 and RR> 1, 95% confidence interval does not contain 1; The seizures and family history of seizure were both P <0.01, with positive values for B, all with RR> 1, and no 95% confidence interval included. Conclusion The onset of FC is prolonged, the total number of episodes is increased. Focal seizures and family history of convulsion are risk factors of secondary EP.