Lee Jeong-Yong, Kim Jung-Heon, Cho Hyung-Rae, Lee Jong-Seung, Ryu Jeong-Min, Yum Mi-Sun, Ko Tae-Sung
Department of Pediatrics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
J Child Neurol. 2016 Mar;31(4):439-43. doi: 10.1177/0883073815597757. Epub 2015 Aug 3.
The risk factors and clinical implications of stress hyperglycemia in children with febrile seizure remain uncertain. Among 479 children with febrile seizure, the prevalence of the stress hyperglycemia (blood glucose concentration ≥ 150 mg/dL) was 10.0%. Stress hyperglycemia group included larger proportion of first-time febrile seizure, prolonged febrile seizure, and smaller proportion of short febrile seizure in comparison with the non-stress hyperglycemia group. Stress hyperglycemia group demonstrated a lower pH and higher lactate levels than the non-stress hyperglycemia group. Multivariate analysis revealed that first-time febrile seizure (aOR = 3.741, P = .004) and prolonged febrile seizure (aOR = 12.855, P < .001) were significant risk factors for stress hyperglycemia. The rate of early febrile seizure recurrence in the emergency department was not different between the groups. These findings suggest that children experiencing first-time or prolonged febrile seizure are prone to stress hyperglycemia, and this can be related to febrile seizure severity. However, stress hyperglycemia is not predictive of early febrile seizure recurrence in the emergency department.
热性惊厥患儿应激性高血糖的危险因素及临床意义仍不明确。在479例热性惊厥患儿中，应激性高血糖（血糖浓度≥150mg/dL）的患病率为10.0%。与非应激性高血糖组相比，应激性高血糖组首次热性惊厥、热性惊厥持续时间延长的比例更高，短暂热性惊厥的比例更低。应激性高血糖组的pH值低于非应激性高血糖组，乳酸水平高于非应激性高血糖组。多因素分析显示，首次热性惊厥（校正比值比[aOR]=3.741，P=.004）和热性惊厥持续时间延长（aOR=12.855，P<.001）是应激性高血糖的重要危险因素。两组在急诊科早期热性惊厥复发率方面无差异。这些发现表明，首次或热性惊厥持续时间延长的患儿易发生应激性高血糖，这可能与热性惊厥的严重程度有关。然而，应激性高血糖并不能预测急诊科早期热性惊厥的复发。
