【摘要】：目的:探討輕度胃腸炎伴嬰幼兒良性驚厥(benign infantile convulsions associated with mild gastroenteritis,BICE)與輪狀病毒的關(guān)聯(lián)性,并比較分析伴輪狀病毒感染病例和非輪狀病毒感染病例臨床表現(xiàn)及實驗室檢查之間的異同。方法:以2008年1月至2016年10月就診于我院兒科的278例BICE患兒為研究對象,根據(jù)糞便人輪狀病毒(human rotavirus,HRV)抗原檢測結(jié)果,分為HRV陽性組與陰性組�；仡櫡治鋈炕純旱呐R床資料,比較兩組患兒在發(fā)病季節(jié)、發(fā)病年齡、性別、臨床表現(xiàn)、血常規(guī)、肝功能、電解質(zhì)之間的異同,尤其是驚厥方面的差異。出院后隨訪6~48個月,回顧分析預(yù)后。結(jié)果:278例入選患兒,其中HRV陽性組42例(15.1%),陰性組236例(84.9%)。HRV陽性組男20例(47.6%),女22例(52.4%)。年齡分布在9~28個月,平均(16.5±4.2)個月。秋冬季發(fā)病31例(73.8.%),春夏季發(fā)病11例(26.2%)。伴發(fā)熱20例(47.6%),不發(fā)熱22例(52.4%)。腹瀉伴嘔吐22例(52.4%),腹瀉18例(42.8%),嘔吐2例(4.8%)。全面性發(fā)作37例(88.1%),部分性發(fā)作5例(11.9%)。首次驚厥發(fā)作于第1天3例(7.1%),第2天10例(23.8%),第3天25例(59.6%),第4天3例(7.1%),第5天1例(2.4%)。驚厥發(fā)作1次4例(9.5%),發(fā)作2次24例(57.2%),發(fā)作3次9例(21.4%),發(fā)作4次3例(7.1%),發(fā)作≥5次2例(4.8%)。42例患兒共發(fā)生驚厥101次,平均2.40次,驚厥持續(xù)時間≤1分鐘32次(31.7%),1~5分鐘68次(67.3%),≥5分鐘1次(1.0%)。HRV陰性組男110例(46.6%),女126例(53.4%);年齡分布在8~34個月,平均(17.8±5.1)個月。秋冬季發(fā)病176例(74.6%),春夏季發(fā)病60例(25.4%)。伴發(fā)熱45例(19.1%),不發(fā)熱191例(80.9%)。腹瀉伴嘔吐118例(50.0%),腹瀉110例(46.4%),嘔吐8例(3.6%)。全面性發(fā)作215例(91.1%),部分性發(fā)作21例(8.9%)。首次驚厥發(fā)作于第1天11例(4.7%),第2天62例(26.3%),第3天137例(58.0%),第4天20例(8.5%),第5天6例(2.5%)。驚厥發(fā)作1次25例(10.6%),發(fā)作2次132例(55.9%),發(fā)作3次52例(22.0%),發(fā)作4次15例(6.4%),發(fā)作≥5次12例(5.1%)。236例患兒共發(fā)生驚厥571次,平均2.42次,驚厥持續(xù)時間≤1分鐘170次(29.8%),1~5分鐘396次(69.4%),≥5分鐘5次(0.8%)。比較兩組間的臨床特點發(fā)現(xiàn),HRV陽性組較陰性組更易出現(xiàn)發(fā)熱,且差異有統(tǒng)計學(xué)意義(P0.05);而在發(fā)病季節(jié)、發(fā)病年齡、性別、嘔吐、腹瀉、驚厥等分布的差異無統(tǒng)計學(xué)意義(P0.05)。在實驗室檢查方面,HRV陽性組較陰性組血清鈉、鈣含量降低,且差異有統(tǒng)計學(xué)意義(P0.05),其余各項指標(biāo)差異無統(tǒng)計學(xué)意義。所有患兒出院后隨訪均未出現(xiàn)神經(jīng)系統(tǒng)后遺癥,其中6例(2.16%)出現(xiàn)復(fù)發(fā),1例(0.36%)出現(xiàn)反復(fù)無熱驚厥,轉(zhuǎn)化為癲癇。結(jié)論:輪狀病毒可引起B(yǎng)ICE;伴輪狀病毒感染組較非輪狀病毒感染組更易出現(xiàn)發(fā)熱,并可伴有一定程度的血鈉、血鈣濃度降低,但尚未達(dá)到引起驚厥的低鈉血癥和低鈣血癥。BICE驚厥出現(xiàn)于病程的第1~5天,以第3天最多見,大部分表現(xiàn)為反復(fù)驚厥發(fā)作或成簇樣發(fā)作。本病預(yù)后良好,無神經(jīng)系統(tǒng)后遺癥,但極少數(shù)患兒存在復(fù)發(fā)情況。
[Abstract]:Objective: to investigate the association between mild gastroenteritis with benign convulsion (benign infantile convulsions associated with mild gastroenteritis,BICE) and rotavirus. The clinical manifestations and laboratory findings of rotavirus infection and non rotavirus infection were compared and analyzed. Methods: 278 children with BICE from January 2008 to October 2016 were divided into HRV positive group and negative group according to the results of stool human rotavirus (human rotavirus,HRV) antigen detection. The clinical data of all the children were retrospectively analyzed and the differences in onset season, age, sex, clinical manifestation, blood routine, liver function and electrolyte, especially in convulsion were compared between the two groups. The patients were followed up for 6 ~ 48 months after discharge and the prognosis was analyzed retrospectively. Results: there were 42 cases (15.1%) in HRV positive group, 236 cases (84.9%) in). HRV positive group, 20 cases (47.6%) in male and 22 cases (52.4%) in female. The age distribution ranged from 9 to 28 months, with an average of (16.5 鹵4.2) months. There were 31 cases (73.8%) in autumn and winter and 11 cases (26.2%) in spring and summer. There were 20 cases (47.6%) with fever and 22 cases (52.4%) with no fever. There were 22 cases (52.4%) of diarrhea with vomiting, 18 cases (42.8%) of diarrhea and 2 cases (4.8%) of vomiting. There were 37 cases (88.1%) of comprehensive seizure and 5 cases (11.9%) of partial attack. The first seizure occurred on the first day (7.1%), the second day in 10 cases (23.8%), the third day in 25 cases (59.6%), the fourth day in 3 cases (7.1%) and the fifth day in 1 case (2.4%). Seizures occurred once in 4 cases (9.5%), twice in 24 cases (57.2%), 3 times in 9 cases (21.4%), 4 times in 3 cases (7.1%). Seizures 鈮，

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