Department of Pediatrics, Atsugi City Hospital, Kanagawa, Japan.
Eur Rev Med Pharmacol Sci. 2020 Nov;24(21):11187-11191. doi: 10.26355/eurrev_202011_23606.
Systemic inflammatory response may contribute to the onset of febrile seizures (FSs). The neutrophil-to-lymphocyte ratio (NLR) has been reported to be useful for differentiating simple and complex FSs in children with a first FS. This study aimed to determine whether easily measurable inflammatory markers were useful for distinguishing between the types of FSs in children with FSs not limited to the first FS.
We conducted a retrospective study of children aged 6-60 months who were presented to the Atsugi City Hospital in Japan for the treatment of FSs between December 2018 and February 2020. A complex FS was defined as a seizure with multiple seizures during the same febrile illness, prolonged seizures and/or focal seizures. A simple FS was defined as a seizure without the characteristics of complex FS. We assessed complete blood count, C-reactive protein, and calculated osmotic pressure.
A total of 205 children with FSs (simple, 139; complex, 66) fulfilled the inclusion criteria. None of the inflammatory markers, including NLR, could predict the FS type. The median osmotic pressure was 279.0, 278.8, 283.3, and 278.3 mOsm/kg H2O for children with simple, multiple, prolonged, and focal seizures, respectively. Children with prolonged seizures had a significantly higher calculated osmotic pressure than those with simple FSs (p<0.001) and multiple seizures during the same febrile illness (p=0.004).
Easily measurable inflammatory markers, including NLR, were not useful for distinguishing between types of FSs in children. Large multicenter studies are needed to evaluate the association between osmotic pressure and FS.
全身炎症反应可能与热性惊厥（FS）的发作有关。有报道称，中性粒细胞与淋巴细胞比值（NLR）有助于区分首次 FS 患儿的单纯性和复杂性 FS。本研究旨在确定是否可通过易于测量的炎症标志物区分 FS 患儿的 FS 类型，而不限于首次 FS。
我们对 2018 年 12 月至 2020 年 2 月期间在日本厚木市医院就诊的年龄为 6-60 个月的 FS 患儿进行了回顾性研究。复杂 FS 定义为同一发热性疾病中出现多次发作、发作持续时间延长和/或局灶性发作的惊厥。单纯性 FS 定义为无复杂 FS 特征的惊厥。我们评估了全血细胞计数、C 反应蛋白，并计算了渗透压。
共有 205 例 FS 患儿（单纯性 FS，139 例；复杂性 FS，66 例）符合纳入标准。包括 NLR 在内的任何炎症标志物均不能预测 FS 类型。单纯性、多次发作、发作持续时间延长和局灶性发作的儿童的渗透压中位数分别为 279.0、278.8、283.3 和 278.3 mOsm/kg H2O。发作持续时间延长的患儿的渗透压明显高于单纯性 FS 患儿（p<0.001）和同一次发热性疾病中出现多次发作的患儿（p=0.004）。
包括 NLR 在内的易于测量的炎症标志物对区分 FS 患儿的 FS 类型没有帮助。需要进行大型多中心研究来评估渗透压与 FS 之间的关联。
