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调查土耳其开塞利高热惊厥的患病率:对高热惊厥复发及癫痫发生的危险因素评估

Investigating the prevalence of febrile convulsion in Kayseri, Turkey: An assessment of the risk factors for recurrence of febrile convulsion and for development of epilepsy.

作者信息

Canpolat Mehmet, Per Huseyin, Gumus Hakan, Elmali Ferhan, Kumandas Sefer

机构信息

Erciyes University Medical School, Department of Pediatrics, Division of Pediatric Neurology, Talas, Kayseri, Turkey.

Erciyes University Medical School, Department of Biostatistics, Talas, Kayseri, Turkey.

出版信息

Seizure. 2018 Feb;55:36-47. doi: 10.1016/j.seizure.2018.01.007. Epub 2018 Jan 10.

Abstract

PURPOSE

The purpose of this study was to investigate the prevalence and recurrence of febrile convulsion (FC) and risk factors for development of epilepsy in school children throughout in the Kayseri provincial center.

METHOD

Ten thousand individuals selected using "stratified cluster sampling" from a student population of 259,428 inside the Kayseri Urban Municipality represented the study sample. Fifteen thousand questionnaires were distributed, of which 10,742 (71.6%) were returned. Telephone interviews were performed with the families of the students reported as having undergone FC, and the medical records of patients with a history of hospitalization were evaluated. Data were analyzed on IBM SPSS Statistics 22.0 package program. Significance was set at p < 0.05.

RESULTS

Prevalence of FC was 4.2% in girls and 4.3% in boys, with a total prevalence of 4.3%. Recurrence of FC was observed in 25.4% of cases. Risk of recurrence increased 7.1 times in subjects with a history of FC in first and second degree relatives, 17.8 times in those with fever interval <1 h before convulsion and 17.6 times in those with pre-convulsion body temperature <39 °C. Epilepsy developed in 33 (7.2%) cases. Neurodevelopmental abnormality was the most important risk factor for epilepsy (21.1-fold risk increase).

CONCLUSIONS

Analysis revealed that FC with a good prognosis had a high rate of recurrence and a higher risk of epilepsy than in the general population. The prevalence of FC in the province of Kayseri was closer to that in developed rather than developing countries.

摘要

目的

本研究旨在调查开塞利省中心地区学龄儿童热性惊厥(FC)的患病率、复发情况以及癫痫发生的危险因素。

方法

采用“分层整群抽样”方法从开塞利市辖区内259,428名学生中选取10,000名个体作为研究样本。共发放15,000份问卷,回收10,742份(71.6%)。对报告有FC病史的学生家庭进行电话访谈,并评估有住院史患者的病历。数据在IBM SPSS Statistics 22.0软件包程序中进行分析。显著性设定为p<0.05。

结果

FC的患病率在女孩中为4.2%,在男孩中为4.3%,总体患病率为4.3%。25.4%的病例观察到FC复发。一级和二级亲属中有FC病史的受试者复发风险增加7.1倍,惊厥前发热间隔<1小时的受试者复发风险增加17.8倍,惊厥前体温<39°C的受试者复发风险增加17.6倍。33例(7.2%)发生癫痫。神经发育异常是癫痫最重要的危险因素(风险增加21.1倍)。

结论

分析显示,预后良好的FC复发率高,癫痫风险高于一般人群。开塞利省FC的患病率更接近发达国家而非发展中国家。

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