Department of Pediatrics, Hirakata City Hospital, Hirakata, Osaka, Japan;
Department of Pediatrics, Hirakata City Hospital, Hirakata, Osaka, Japan.
Pediatrics. 2018 Nov;142(5). doi: 10.1542/peds.2018-1009. Epub 2018 Oct 8.
To confirm the safety of using acetaminophen for febrile seizures (FSs) and to assess its efficacy in preventing FS recurrence during the same fever episode.
In this single-center, prospective, open, randomized controlled study, we included children and infants (age range: 6-60 months) with FSs who visited our hospital between May 1, 2015, and April 30, 2017. The effectiveness of acetaminophen was examined by comparing the recurrence rates of patients in whom rectal acetaminophen (10 mg/kg) was administered every 6 hours until 24 hours after the first convulsion (if the fever remained >38.0°C) to the rates of patients in whom no antipyretics were administered. No placebo was administered to controls. The primary outcome measure was FS recurrence during the same fever episode.
We evaluated 423 patients; of these, 219 were in the rectal acetaminophen group, and 204 were in the no antipyretics group. In the univariate analysis, the FS recurrence rate was significantly lower in the rectal acetaminophen group (9.1%) than in the no antipyretics group (23.5%; < .001). Among the variables in the final multiple logistic regression analysis, rectal acetaminophen use was the largest contributor to the prevention of FS recurrence during the same fever episode (odds ratio: 5.6; 95% confidence interval: 2.3-13.3).
Acetaminophen is a safe antipyretic against FSs and has the potential to prevent FS recurrence during the same fever episode.
确认使用对乙酰氨基酚治疗热性惊厥（FS）的安全性，并评估其在同一发热期内预防 FS 复发的疗效。
在这项单中心、前瞻性、开放、随机对照研究中，我们纳入了 2015 年 5 月 1 日至 2017 年 4 月 30 日期间因 FS 就诊于我院的儿童和婴儿（年龄范围：6-60 个月）。通过比较直肠给予对乙酰氨基酚（10mg/kg）每 6 小时一次直至首次惊厥后 24 小时（如果发热仍>38.0°C）的患者与未给予退热剂的患者的复发率，来检验对乙酰氨基酚的有效性。对照组未给予安慰剂。主要结局指标为同一发热期内 FS 的复发。
我们评估了 423 例患者；其中，219 例在直肠对乙酰氨基酚组，204 例在未用退热剂组。单因素分析显示，直肠对乙酰氨基酚组 FS 复发率（9.1%）明显低于未用退热剂组（23.5%；<.001）。在最终多变量逻辑回归分析中的变量中，直肠使用对乙酰氨基酚是同一发热期内预防 FS 复发的最大贡献因素（比值比：5.6；95%置信区间：2.3-13.3）。
对乙酰氨基酚是治疗 FS 的安全退热剂，并有潜力预防同一发热期内 FS 的复发。
