Scher M S, Hamid M Y, Steppe D A, Beggarly M E, Painter M J
Developmental Neurophysiology Laboratory, Magee-Womens Hospital, Pittsburgh, PA 15213-3180.
Epilepsia. 1993 Mar-Apr;34(2):284-8. doi: 10.1111/j.1528-1157.1993.tb02412.x.
The effect of gestational age on neonatal ictal and interictal durations has not been investigated. Sixty-eight neonates with 644 electrographic seizures were identified retrospectively. Thirty-five full-term (FT) neonates were compared with 33 preterm (PT) neonates. Eighteen older preterm infants (OPT) [> 31 weeks estimated gestational age (EGA)] were also compared with 15 young preterm infants (YPT) of < or = 31 weeks EGA. Ictal/interictal durations were calculated for the total cohort with and without status epilepticus (SE). Statistical analyses were two-tailed t tests, chi-square calculations, and one-way analysis of variance (ANOVA) with Duncan's multiple-range test. Eleven of 35 (33%) FT had SE as compared with 3 of 33 (9%) PT (chi-square = 7.8, p < 0.05). The mean ictal duration was 14.2 min for FT infants as compared with 3.1 min for PT infants (p < 0.01); only borderline differences were noted after those with SE were excluded. Interictal durations were longer for OPT than YPT (p < 0.05). By ANOVA and Duncan's multiple-range tests, group differences included longer mean ictal durations for FT infants as compared with OPT infants (p = 0.06, ANOVA; p < 0.05, Duncan's), and longer mean interictal durations for FT infants versus OPT and OPT versus YPT (p = 0.02, ANOVA; p < 0.05, Duncan's). More developed neuronal networks result in longer ictal durations in FT than in PT neonates, including FT infants with SE.(ABSTRACT TRUNCATED AT 250 WORDS)
胎龄对新生儿发作期和发作间期时长的影响尚未得到研究。对68例有644次脑电图痫性发作的新生儿进行了回顾性分析。将35例足月儿(FT)与33例早产儿(PT)进行比较。还将18例孕周较大的早产儿(OPT)[估计胎龄(EGA)>31周]与15例EGA≤31周的孕周较小的早产儿(YPT)进行比较。计算了有和无癫痫持续状态(SE)的整个队列的发作期/发作间期时长。统计分析采用双侧t检验、卡方计算以及单因素方差分析(ANOVA)和邓肯多重极差检验。35例FT中有11例(33%)发生SE,而33例PT中有3例(9%)发生SE(卡方=7.8,p<0.05)。FT婴儿的平均发作期时长为14.2分钟,而PT婴儿为3.1分钟(p<0.01);排除有SE的婴儿后仅发现临界差异。OPT的发作间期时长比YPT长(p<0.05)。通过ANOVA和邓肯多重极差检验,组间差异包括FT婴儿的平均发作期时长比OPT婴儿长(p=0.06,ANOVA;p<0.05,邓肯检验),以及FT婴儿的平均发作间期时长比OPT婴儿长,OPT婴儿比YPT婴儿长(p=0.02,ANOVA;p<0.05,邓肯检验)。更发达的神经网络导致FT新生儿的发作期时长比PT新生儿长,包括有SE的FT婴儿。(摘要截断于250字)