CAJ | 학술논문

目的：回顾性分析伴海马硬化癫痫患者的临床资料，探讨热性惊厥与海马硬化的关系。方法507例癫痫患者由MRI证实伴海马硬化。根据儿童期是否出现热性惊厥，将患者分为两组：即热性惊厥组（ FS＋组）和无热性惊厥组（ FS-组），进一步将FS＋组分为1岁以内亚组和1～5岁亚组。采用卡方检验和t检验对两组和两亚组在性别、非热性发作起始年龄、热性惊厥年龄与非热性发作间的间隔时间、海马硬化出现的单双侧以及是否实施癫痫手术等参数进行统计学比较。结果507例患者中，热性惊厥史阳性者88例，占17.4％。癫痫非热性发作平均起病年龄FS＋组明显低于FS-组[（10.5±6.4）岁vs．（15.7±10.8）岁，P＝0.000]。实施手术治疗的比例FS＋组稍多于FS-组[37例（42.0％）vs．135例（32.2％），P＝0.051]。 FS＋组和FS-组及FS＋亚组在性别、海马硬化的单双侧等参数比较无统计学差异。 FS＋亚组在非热性发作平均起病年龄、FS年龄与非热性发作间的间隔时间、是否实施手术等方面无统计学差异。 FS＋组接受手术治疗的患者病程明显长于药物治疗者[（8.1±4.4）年vs．（7.1±6.9）年，P＝0.009]。手术治疗随访者中92.3％达EngelⅠ级。结论伴海马硬化的癫痫患者中儿童期出现热性惊厥史者，出现癫痫非热性发作的平均起病年龄明显早于无热性惊厥史的海马硬化癫痫患者；这部分患者可能进行癫痫手术治疗的预后更好。
목적：회고성분석반해마경화전간환자적림상자료，탐토열성량궐여해마경화적관계。방법507례전간환자유MRI증실반해마경화。근거인동기시부출현열성량궐，장환자분위량조：즉열성량궐조（ FS＋조）화무열성량궐조（ FS-조），진일보장FS＋조분위1세이내아조화1～5세아조。채용잡방검험화t검험대량조화량아조재성별、비열성발작기시년령、열성량궐년령여비열성발작간적간격시간、해마경화출현적단쌍측이급시부실시전간수술등삼수진행통계학비교。결과507례환자중，열성량궐사양성자88례，점17.4％。전간비열성발작평균기병년령FS＋조명현저우FS-조[（10.5±6.4）세vs．（15.7±10.8）세，P＝0.000]。실시수술치료적비례FS＋조초다우FS-조[37례（42.0％）vs．135례（32.2％），P＝0.051]。 FS＋조화FS-조급FS＋아조재성별、해마경화적단쌍측등삼수비교무통계학차이。 FS＋아조재비열성발작평균기병년령、FS년령여비열성발작간적간격시간、시부실시수술등방면무통계학차이。 FS＋조접수수술치료적환자병정명현장우약물치료자[（8.1±4.4）년vs．（7.1±6.9）년，P＝0.009]。수술치료수방자중92.3％체EngelⅠ급。결론반해마경화적전간환자중인동기출현열성량궐사자，출현전간비열성발작적평균기병년령명현조우무열성량궐사적해마경화전간환자；저부분환자가능진행전간수술치료적예후경호。
Objective To explore the clinical relationship between febrile seizure ( FS) and epilepsy with hippocampal sclerosis ( HS) .Methods A retrospective survey was made in Epileptic Center of Guangdong 999 Brain Hospital from October 2001 to December 2009.507 cases with hippocampol sclerosis were confirmed by cranial MRI . We compared clinical features from 88 patients with FS and 419 patients without FS .Clinical features from two subgroups with different FS ages ,which were FS age below 1 year and FS age between 1 and 5 years,were also compared by Fisher′s exact tests and t tests.Results Age at epilepsy onset was lower in patients with FS ( t =4.392 ,P=0.000 ) .Patients with FS were more likely to conduct operation than those without FS ( P=0.051 ) .There were no statistical differences between 2 groups and 2 subgroups ,in terms of gender and side of HS .Ages of FS had no means with age at epilepsy onset ,interval time and whether to execute operation .Duration of patients with FS who had operation may be longer that those had medications , but 92.3% of postoperating patients with FS may achieve good outcome of EngelⅠlevel.Conclusion Age at epilepsy onset was lower in patients with FS and they were more likely to have operation and gain better outcomes .