目的 分析影响脑性瘫痪(CP)患儿合并癫痫的危险因素,为防治CP患儿癫痫的发作提供参考。方法 回顾性分析2008年5月-2015年1月我院477例CP患儿的临床资料,按照患儿入院时有无癫痫发作分为癫痫发作组(病例组)和无癫痫发作组(对照组),对两组患儿的一般临床资料及影像学资料等进行比较,并对脑性瘫痪患儿继发癫痫的相关因素进行二分类非条件Logistic回归分析。结果 纳入的477例CP患儿中有86例合并癫痫(18.0%),癫痫患儿以四肢瘫最多见(61.6%),强直阵挛性发作是癫痫发作的主要类型(44.2%);多因素Logistic回归分析提示低出生体重(OR=2.793,P<0.05)、脑软化(OR=3.185,P<0.05)、颅内出血(OR=3.581,P<0.05)、脑结构畸形(OR=5.839,P<0.05)是CP患儿合并癫痫的独立危险因素。结论 CP患儿中具有脑软化、颅内出血、低出生体重及脑结构畸形的发生癫痫的风险显著增高,应当给予临床重视。
Abstract
Objective To analysis the risk factors of cerebral palsy (CP) children with secondary epilepsy risk factors and provide reference for the prevention and treatment of CP children with epilepsy seizures. Methods Clinical data of 477 cases of children with CP in our hospital from May 2008 to January 2015 were retrospective analyzed.According to the children in hospital had seizures or not,children were divided into epilepsy group (case group) and the non-epilepsy group (control group),the general clinical data and imaging data of two groups were comparied,and the related factors were analyzed by Logistic regression analysis. Results In 477 patients with CP,86 cases merge epilepsy (18.0%),most (61.6%) children with epilepsy with tetraplegia,stiffness matrix cramps seizure was the main type of seizures (44.2%).Multiariable Logistic regression analysis suggested that low birth weight (OR=2.793,P<0.05),the softening of the brain (OR=3.185,P<0.05),intracranial hemorrhage (OR=3.581,P<0.05),the structure of the brain malformation (OR=5.839,P<0.05) were independent risk factors of CP children with epilepsy. Conclusions In children with CP,a softening of the brain,intracranial hemorrhage,low birth weight and brain structure abnormalities significantly increased the risk of epilepsy,which should be given clinical attention.
关键词
癫痫 /
脑性瘫痪 /
儿童 /
危险因素
Key words
epilepsy /
Cerebral palsy /
Children /
Risk factors for
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参考文献
[1] 王军,张贞焕,朱登纳,等.河南省小儿脑性瘫痪流行特征及防治现状[J].中国妇幼保健,2013,13(11):2109-2112.
[2] Jerome Engel J.A Proposed diagnostic scheme for people with epileptic seizures and with epilepsy:report of the ilea task force on classification and terminology[J].Epilepsia,2011,42(6):796-803.
[3] Carls son M,Olss on I,Hagberg G,et al.Behaviour in children with cerebral palsy with and without epilepsy[J].Dev Med Child Neurol,2008,50(10):784-789.
[4] Jaseja H.Cerebral palsy:Interracial epileptic form discharges and cognitive impairment[J].Clin Neurol Neurosurg,2007,109(7):549- 552.
[5] Nathanel Z,Muriel K,Odeya BB,et al.The risk factors for epilepsy in children with cerebral palsy[J].European Journalof Paediatric Neurology,2010,14 (1):67-72.
[6] 文香淑,邓富萍,张金梅.脑性瘫痪合并癫痫的临床和预后[J].中国伤残医学,2010,22(1):25-27.
[7] Rahman MM,Akhter S,Karim Co Epilepsy in children with cerebral palsy[J].Journal of Parts Med J,2012,13 (2):219-223.
[8] 赖娅莉,孙红斌.星形胶质细胞在癫痫发病机制中的作用研究进展[J].实用医院临床杂志,2011,8 (4):202-205.
[9] 潘炜,胡晓,袁平,等.谷氨酸与癫痫发病机制相关性研究进展[J].贵州医药,2014,12(6):565-568.
[10] 彭桂兰,胡恕香,李银兰.小儿脑性瘫痪癫痫风险因素分析[J].中国儿童保健杂志,2013,12(7):726-728.
[11] Sliwa A,Plucinska G,Bednarczyk J,et al.Post-treatment with rapamycindoes not prevent epileptogenesis in the amygdala stimulationmodel of temporal lobe epilepsy[J].Neurosci Lett,2012,509(2):105-109.