CAJ | 학술논문

目的：探讨脑性瘫痪( cerebral palsy, CP)患儿合并癫痫的相关因素,为临床防治CP患儿继发癫痫、改善患儿预后提供参考。方法回顾性分析苏州大学附属儿童医院2006年9月—2014年2月收治的477例CP患儿的临床资料,包括一般临床资料及影像学资料,并对CP患儿继发癫痫的相关因素进行多因素Logistic回归分析。结果477例CP患儿中,86例出现癫痫发作,发生率为18.0%。86例患儿中癫痫发作类型以强直阵挛性发作为主(44．2%),其次为肌阵挛发作(29.1%)；CP类型以四肢瘫最多见(61.6%)。多因素Logistic回归分析显示,出生低体重(OR=3.583,P <0．01)、颅内出血(OR =2.793,P <0．01)、脑软化(OR =5.845,P <0．01)、脑结构畸形(OR =3．184,P<0．01)是CP患儿合并癫痫的独立危险因素。结论临床对有出生时低体重、颅内出血史,影像学表现为脑软化、脑结构畸形的CP患儿应密切关注,以防继发癫痫。
목적：탐토뇌성탄탄( cerebral palsy, CP)환인합병전간적상관인소,위림상방치CP환인계발전간、개선환인예후제공삼고。방법회고성분석소주대학부속인동의원2006년9월—2014년2월수치적477례CP환인적림상자료,포괄일반림상자료급영상학자료,병대CP환인계발전간적상관인소진행다인소Logistic회귀분석。결과477례CP환인중,86례출현전간발작,발생솔위18.0%。86례환인중전간발작류형이강직진련성발작위주(44．2%),기차위기진련발작(29.1%)；CP류형이사지탄최다견(61.6%)。다인소Logistic회귀분석현시,출생저체중(OR=3.583,P <0．01)、로내출혈(OR =2.793,P <0．01)、뇌연화(OR =5.845,P <0．01)、뇌결구기형(OR =3．184,P<0．01)시CP환인합병전간적독립위험인소。결론림상대유출생시저체중、로내출혈사,영상학표현위뇌연화、뇌결구기형적CP환인응밀절관주,이방계발전간。
Objective To investigate related factors for children with cerebral palsy ( CP) complicated by epi-lepsy in order to provide clinical references for prevention and treatment of secondary epilepsy and improve the prognosis of cerebral palsy children. Methods Clinical data of 477 CP children during September 2006 and February 2014 was retrospectively analyzed, which included general clinical data and imaging examination data, and multiple factors of Lo-gistic regression analysis was performed for the possible related factors in CP children with secondary epilepsy. Results Among the 477 CP children, 86 children had epileptic attack, and the incidence rate was 18. 0%. The main type of epi-lepsy in the 86 children was tonic-clonic seizures (44. 2%) followed by myoclonic seizures (29. 1%);quadriplegia was the most common type in the 86 children with epilepsy (61. 6%). The multivariable Logistic Regression Analysis showed that independent risk factors for children with CP complicated by epilepsy were low birth weight ( OR =3. 583, P <0. 01), intracranial hemorrhage (OR=2. 793, P<0. 01), softening of brain (OR=5. 845, P<0. 01) and brain struc-tural abnormalities (OR=3. 184, P<0. 01). Conclusion Children with cerebral palsy have low birth weight, intracra-nial hemorrhage, softening of brain and brain structural abnormalities. Close attention should be paid to those patients to prevent secondary epilepsy.