Division of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
Department of Pediatrics, University Hospital of Patras, Patras, Greece.
PLoS One. 2015 Apr 20;10(4):e0124663. doi: 10.1371/journal.pone.0124663. eCollection 2015.
Accurate diagnosis of febrile seizures in children presenting after paroxysmal episodes associated with fever, is hampered by the lack of objective postictal biomarkers. The aim of our study was to investigate whether FS are associated with increased levels of serum copeptin, a robust marker of arginine vasopressin secretion.
This was a prospective emergency-setting cross-sectional study of 161 children between six months and five years of age. Of these, 83 were diagnosed with febrile seizures, 69 had a febrile infection without seizures and nine had epileptic seizures not triggered by infection. Serum copeptin and prolactin levels were measured in addition to standard clinical, neurophysiological, and laboratory assessment.
NCT01884766.
Circulating copeptin was significantly higher in children with febrile seizures (median [interquartile range] 18.9 pmol/L [8.5-36.6]) compared to febrile controls (5.6 pmol/L [4.1-9.4]; p < 0.001), with no differences between febrile and epileptic seizures (21.4 pmol/L [16.1-46.6]; p = 0.728). In a multivariable regression model, seizures were the major determinant of serum copeptin (beta 0.509; p < 0.001), independently of clinical and baseline laboratory indices. The area under the receiver operating curve for copeptin was 0.824 (95% CI 0.753-0.881), significantly higher compared to prolactin (0.667 [0.585-0.742]; p < 0.001). The diagnostic accuracy of copeptin increased with decreasing time elapsed since the convulsive event (at 120 min: 0.879 [0.806-0.932] and at <60 min: 0.975 [0.913-0.997]).
Circulating copeptin has high diagnostic accuracy in febrile seizures and may be a useful adjunct for accurately diagnosing postictal states in the emergency setting.
由于缺乏客观的发作后生物标志物，儿童在发热性惊厥发作后出现阵发性发作时，准确诊断发热性惊厥受到阻碍。我们的研究目的是探讨 FS 是否与血清 copeptin 水平升高有关，c opeptin 是血管加压素分泌的有力标志物。
这是一项前瞻性急诊设置的横断面研究，共纳入 161 名 6 个月至 5 岁的儿童。其中 83 例诊断为热性惊厥，69 例为发热性感染但无惊厥，9 例为非感染性癫痫发作。除了标准的临床、神经生理学和实验室评估外，还测量了血清 copeptin 和催乳素水平。
NCT01884766。
发热性惊厥患儿循环 copeptin 明显高于发热对照组（中位数[四分位间距] 18.9 pmol/L [8.5-36.6] 比 5.6 pmol/L [4.1-9.4]；p < 0.001），发热性惊厥与癫痫性惊厥之间无差异（21.4 pmol/L [16.1-46.6]；p = 0.728）。在多变量回归模型中，惊厥是血清 copeptin 的主要决定因素（β 0.509；p < 0.001），独立于临床和基线实验室指标。c opeptin 的受试者工作特征曲线下面积为 0.824（95%CI 0.753-0.881），明显高于催乳素（0.667 [0.585-0.742]；p < 0.001）。随着惊厥事件后时间的缩短，c opeptin 的诊断准确性增加（120 分钟时为 0.879 [0.806-0.932]，<60 分钟时为 0.975 [0.913-0.997]）。
循环 copeptin 在热性惊厥中具有较高的诊断准确性，可能是急诊准确诊断发作后状态的有用辅助手段。
