Analysis Of Clinical Characteristics Of Changes In Na⁺,Ca²⁺,Glucose And Lactic Acid Concentrations In Children With Febrile Convulsion

PurposeFebrile convulsion is the most common critical disease in pediatric emergency department.Convulsion attack will put the body in a state of stress,prone to be accompanied by electrolyte imbalance and acid-base imbalance.This topic mainly studies the blood gas test indicators of febrile seizures,and studies the clinical characteristic of children with abnormal blood gas.So that clinicians can early identify the blood gas changes in children with febrile convulsion and its related clinical features,active treatment to avoid secondary brain damage is of great significance to improve the prognosis of febrile convulsions.MethodsIn this study,data were collected from December 1,2018,to November 31,2019,the medical ward of Shenyang Children’s Hospital treated 378 children with febrile convulsion and acute upper respiratory tract infection（febrile convulsion group）and269 children with acute upper respiratory tract infection and fever（control group）.Between 6 months and 5 years old.After admission and before special treatment,venous blood samples were collected for blood gas examination,and the Beckman AU 5800 blood gas analyzer was used for blood gas analysis to detect Na⁺,K⁺,Cl^-,Ca²⁺,PH,HCO₃^-,BE,glucose and Lactic acid.Compare two groups have statistical significance of the assay index,according to the value,it is further divided into normal group,elevated group and lower group.The clinical characteristics of child convulsions are analyzed,including gender,age,number of convulsions in 24 hours,duration of single convulsions,seizures at body temperature,and video EEG results.SPSS22.0 software package was used to analyze the data.The obtained values were expressed as（（?）±s） and M（P25,P75）.T-test and Mann-whitney U test were used to compare the measurement data,χ² test and Fisher’s exact probability method were used for the enumeration data.P<0.05 indicates that the difference is statistically significant.To explore the variation rule of febrile convulsion blood gas and its relationship with clinical characteristics.Results1.There was no significant difference in the contents of K⁺、Cl^-、PH、HCO₃^-and BE between the two groups（P>0.05）,but there was significant difference in the concentrations of Na⁺,Ca²⁺,blood glucose and lactic acid（P<0.05）,the concentration of Na⁺and Ca²⁺in blood of febrile convulsion group was lower than that of control group,and the concentration of glucose and lactic acid in blood was higher than that of control group.2.The content of Na⁺in blood samples of FS Group was 127.2 mmol/L～146.2mmol/L,46 cases（12.17%）of hyponatremia group,332 cases（87.83%）of normal group.There were significant differences between the normal or decreased serum sodium concentration and the age of the child,the number of convulsions in 24 hours,the duration of convulsions,and the results of video EEG（P<0.05）.There was no significant difference in gender and body temperature between the two groups（P>0.05）.The decline in sodium concentration is more common in ages≤3 years,more than one convulsion in 24 hours,and duration of convulsion greater than or equal to 10min.Decreated sodium concentration is more likely to lead to abnormal video electroencephalogram results.3.In FS Group,the Ca²⁺concentration in blood samples ranged from 1.03mmol/L to 1.272 mmol/L,96 cases（25.40%）of Ca²⁺reduction group and 282 cases（74.60%）of Ca²⁺normal group.There was a statistically significant difference between the normal or decreased Ca²⁺concentration in the blood gas and the children’s age,convulsion duration,and video EEG results（P<0.05）;and the difference between gender,the number of seizures in 24 hours,and the body temperature at the time of convulsion No statistical significance（P>0.05）.In cases of age≤3 years old and convulsion duration≥10 min,it is easy to be accompanied by a decrease in calcium ion concentration;the video EEG results of patients with a decrease in blood calcium concentration are more likely to indicate abnormalities.4.In FS Group,blood glucose concentration ranged from 3.3 mmol/L to 9.3mmol/L,9 cases（2.38%）of hypoglycemic group,172 cases（45.50%）of normal blood glucose group,and 197 cases（52.12%）of increased blood glucose group.The changes in blood glucose concentration were significantly different from age,number of seizures in 24 hours,and duration of seizures（P<0.05）;there was no significant difference in comparison with gender,body temperature at the time of seizures,and video EEG results（P>0.05）.Patients with age≤3 years,one seizure within 24 hours,and duration of convulsions<10 min were more likely to be associated with elevated blood glucose concentration in blood gas.5.In FS Group,the lactate concentration in blood samples ranged from 1.1mmol/L to 4.7 mmol/L,70 cases（18.52%）of normal blood lactate group,and 308cases（81.48%）of high blood lactate group.There was a significant differences in age,body temperature and video EEG results between the normal or elevated blood lactic acid concentration.（P<0.05）,and there were no significant differences in gender,number of seizures in 24 hours,and duration of seizures（P>0.05）.In the age≤3years,the body temperature at convulsion≥38.5℃are easy to accompany the elevation of lactic acid concentration.Elevated lactate levels are more likely to lead to abnormal EEG results.Conclusions1.Febrile convulsion in children is easy to be accompanied by electrolyte disorder and acid-base imbalance,which can be manifested as the decrease of Na⁺,Ca²⁺concentration in blood and the increase of glucose and lactic acid concentration,Especially in the age of 3 years or less in infants.2.Among children with febrile seizures,those with a seizure duration≥10 min are likely to be accompanied by a decrease in blood sodium and calcium concentration,and those with a seizure duration<10 min are likely to be accompanied by an increase in blood glucose concentration.3.Patients with 24 hours convulsion more than 1 time were more likely to be associated with decreased serum sodium concentration,while those with 24h convulsion only 1 time were more likely to be associated with increased blood glucose concentration.The elevated lactic acid concentration was associated with the body temperature≥38.5℃during convulsion.4.Among children with febrile seizures,those with decreased blood Na⁺and Ca²⁺concentrations and increased blood lactic acid concentration have an increased risk of abnormalities due to video EEG results.