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热性惊厥患儿原发性人疱疹病毒6型感染的病例对照研究

Case-control study of primary human herpesvirus 6 infection in children with febrile seizures.

作者信息

Hukin J, Farrell K, MacWilliam L M, Colbourne M, Waida E, Tan R, Mroz L, Thomas E

机构信息

Division of Pediatric Neurology, University of British Columbia and British Columbia's Children's Hospital, Vancouver, British Columbia.

出版信息

Pediatrics. 1998 Feb;101(2):E3. doi: 10.1542/peds.101.2.e3.

Abstract

RATIONALE

Human herpesvirus 6 (HHV-6) has been demonstrated to be the causative agent in roseola infantum. It has been suggested that HHV-6 may have neurotropic properties and be involved in the pathogenesis of febrile seizures in infants. We describe a case-control study to examine the hypothesis that acute HHV-6 infection occurs more commonly in children with febrile seizures than in controls.

METHODS

Patients presenting with a first or second febrile seizure between 6 months and 2 years of age were entered in the study. Control patients did not have a seizure but had similar inclusion and exclusion criteria. Specimens were obtained for HHV-6 viral serology and polymerase chain reaction in the acute stage and approximately 2 weeks later. A diagnosis of HHV-6 infection was based on HHV-6-specific IgM and IgG serology and HHV-6 polymerase chain reaction of peripheral blood mononuclear cells and saliva.

RESULTS

Eighty-six patients (45 with febrile seizures; 41 controls) were enrolled. The HHV-6 infection status could be determined in only 68 patients (35 with febrile seizures; 33 controls). Acute HHV-6 infection was identified in 15 of 35 febrile seizure patients and in 15 of 33 controls. Evidence of past HHV-6 infection was demonstrated in 13 febrile seizure patients and in 8 controls.

CONCLUSIONS

The incidence of primary HHV-6 infection is similar in patients with febrile seizures and age-matched controls. HHV-6 does not seem to be a major factor in the pathogenesis of first and second febrile seizures.

摘要

理论依据

人类疱疹病毒6型(HHV-6)已被证实是幼儿急疹的病原体。有人提出,HHV-6可能具有嗜神经性,并参与婴儿热性惊厥的发病机制。我们描述了一项病例对照研究,以检验急性HHV-6感染在热性惊厥儿童中比在对照组中更常见这一假设。

方法

纳入6个月至2岁之间首次或第二次出现热性惊厥的患者进行研究。对照患者未发生惊厥,但具有相似的纳入和排除标准。在急性期和大约2周后采集标本进行HHV-6病毒血清学和聚合酶链反应检测。HHV-6感染的诊断基于HHV-6特异性IgM和IgG血清学以及外周血单个核细胞和唾液的HHV-6聚合酶链反应。

结果

共纳入86例患者(45例热性惊厥患者;41例对照)。仅68例患者(35例热性惊厥患者;33例对照)的HHV-6感染状态可被确定。35例热性惊厥患者中有15例以及33例对照中有15例被鉴定为急性HHV-6感染。13例热性惊厥患者和8例对照中有既往HHV-6感染的证据。

结论

热性惊厥患者和年龄匹配的对照中,原发性HHV-6感染的发生率相似。HHV-6似乎不是首次和第二次热性惊厥发病机制中的主要因素。

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