目的 了解脑瘫患儿高危因素、临床特点及其与癫痫发生的关系,探讨脑瘫患儿共患癫痫的危险因素。方法 回顾性收集从2019年1月—2022年2月在郑州大学第三附属医院住院治疗的脑瘫患儿的病例资料,将患儿分为脑瘫共患癫痫组和未共患癫痫组,采用χ2检验分析两组间高危因素、临床特点等资料,应用多因素Logistic回归对共患癫痫的危险因素进行分析。结果 共纳入630例脑瘫患儿,其中男421例,女209例;脑瘫共患癫痫组患儿155例,未共患癫痫组患儿475例,癫痫发生率24.6%。脑瘫共患癫痫组患儿在宫内窘迫、窒息、多胎及新生儿先天性畸形史方面的发生率高于未共患癫痫组患儿(χ2＝4.788、9.368、5.255、12.111,P＜0.05),两组患儿在脑瘫分型、头颅MRI分类、粗大运动功能分级方面差异有统计学意义(χ2＝213.686、14.640、481.531,P＜0.05)。多因素Logistic回归结果显示,痉挛型四肢瘫(OR=14.090,95%CI:1.950~101.813)、新生儿先天性畸形史(OR=1.891,95%CI:1.155~3.095)、围生期窒息史(OR=1.527,95%CI:1.034~2.255)可能是脑瘫患儿共患癫痫的危险因素(P＜0.05)。结论 脑瘫患儿共患癫痫的发病率较高,病情重,识别危险因素可以为针对性的临床治疗提供依据。
Abstract
Objective To analyze the association of high risk factors and clinical characteristics of cerebral palsy with epilepsy in children, and to explore the risk factors of epilepsy in children with cerebral palsy. Methods Data of children with cerebral palsy hospitalized in the Third Affiliated Hospital of Zhengzhou University from January 2019 to February 2022 were collected retrospectively, and the children were divided into two groups:cerebral palsy with epilepsy group and non-epilepsy group. The difference of high risk factors and clinical characteristics between the two groups was analyzed by χ2 test, and multivariate Logistic regression was used to analyze the risk factors of common epilepsy. Results A total of 630 children with cerebral palsy were included, including 421 boys and 209 girls. There were 155 children with epilepsy in the cerebral palsy group and 475(24.6%) children in the non-epilepsy group. The prevalence rate of intrauterine distress, asphyxia, multiple births and congenital malformation in the cerebral palsy group were higher than those in the non-epilepsy group(χ2=4.788, 9.368, 5.255, 12.111, P＜0.05). There were significant differences in cerebral palsy classification, Magnetic Resonance Imaging Classification System(MRICS) and Gross Motor Function Classification System (GMFCS) between the two groups(χ2=213.686, 14.640, 481.531, P＜0.05). Spastic quadriplegia (OR=14.090, 95%CI:1.950 - 101.183), history of congenital malformation (OR=1.891, 95%CI:1.155 - 3.095) and history of asphyxia (OR=1.527, 95%CI:1.034 - 2.255) may be the risk factors of epilepsy in children with cerebral palsy (P<0.05). Conclusion Epilepsy in children with cerebral palsy is severe and had high prevalence rate, identifying risk factors can provide basis for targeted clinical treatment.
关键词
脑性瘫痪 /
癫痫 /
粗大运动功能分级
Key words
cerebral palsy /
epilepsy /
Gross Motor Function Classification
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基金
2018年度河南省医学科技攻关计划省部共建项目(SBGJ2018047);国家卫生计生委医院管理研究生(ZDSFY-2018-JYB-10)
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