Offringa M, Derksen-Lubsen G, Bossuyt P M, Lubsen J
Erasmus Universiteit, Centrum voor Klinische Besliskunde, Rotterdam.
Ned Tijdschr Geneeskd. 1992 Mar 14;136(11):516-21.
The results of a follow up study of 155 Dutch children who visited the emergency room of an urban paediatric hospital after experiencing their first febrile seizure are presented. Median follow up time was 38 months (range 27-60). Of these 155 initially untreated children 58 (37%) suffered at least one, 47 (30%) at least two and 27 (17%) at least three recurrent seizures. The recurrence hazard after any seizure was highest in the first six months, and dropped markedly after 6 months without seizures. The effect of the various postulated risk factors on the occurrence of any recurrent seizure and three or more recurrences was assessed. A first degree family history of febrile or nonfebrile seizures appears to be a predictor of multiple recurrences; an age of at least 30 months and a temperature of 40.0 degrees C or higher at the initial seizure are associated with a decreased risk. Several factors act together on the risk of recurrent seizures, sometimes in opposite directions. By considering the action of all relevant factors (age at onset, family history and features of the initial febrile seizure) subgroups of children with one year seizure recurrence rates as low as 15% and as high as 48% were identified.
本文呈现了一项针对155名荷兰儿童的随访研究结果，这些儿童在首次热性惊厥后前往一家城市儿科医院的急诊室就诊。随访时间中位数为38个月（范围27 - 60个月）。在这155名最初未接受治疗的儿童中，58名（37%）至少经历了一次复发惊厥，47名（30%）至少经历了两次，27名（17%）至少经历了三次复发惊厥。任何一次惊厥后的复发风险在前六个月最高，在无惊厥6个月后显著下降。评估了各种假定风险因素对任何复发惊厥以及三次或更多次复发的发生的影响。热性或非热性惊厥的一级家族史似乎是多次复发的一个预测因素；初始惊厥时年龄至少30个月且体温达到40.0摄氏度或更高与风险降低相关。几个因素共同作用于复发惊厥的风险，有时作用方向相反。通过考虑所有相关因素（发病年龄、家族史和初始热性惊厥的特征），确定了一年惊厥复发率低至15%和高至48%的儿童亚组。
