Clinical And Predictor Ratio Analysis Of Infantile Spasms Secondary To Hypoglycemic Brain Injuryitis

Hypoglycemia is a common condition in neonatology.More than 50% of healthy newborns have high risk factors for hypoglycemia.The incidence of hypoglycemia in healthy full-term infants is 1% to 5%.Prolonged and severe hypoglycemia can cause irreversible damage to the brain's nerve cells,brain damage caused by hypoglycemia can cause children with motor retardation,visual disturbances,learning and behavioral difficulties,and long-term seizures,and the injury site is mainly occipital.Previous studies have suggested that the occurrence of infantile spasms may be associated with impaired occipital area,and epileptic discharges of early electroencephalograms in infants with infantile spasms are also susceptible to the occipital area.Infantile spasms(IS),also known as West syndrome,is a common age-dependent epileptic encephalopathy in infancy.The etiology is complex and diverse.The pathogenesis is still unclear.Typical clinical features include epileptic seizures.,EEG peak loss,severe mental motor development delay,the disease control rate is low,the recurrence rate is high,so the children with no effective control of the long-term prognosis is poor,poor prognosis is mainly manifested as motor retardation,mental behavior Disorders,autism spectrum disorders,intractable seizures,etc.,some children may be converted to other forms of epilepsy later,such as LG syndrome(Lennox-Gastaut Syndrome),seriously affect the quality of life of children,and even lead to death.At present,the common cause of infantile spasms is known to include perinatal brain injury,congenital brain development abnormalities,brain trauma,genetic metabolic diseases,and infectious factors.Among the numerous secondary factors that cause infantile spasms,There have been a lot of studies on hypoxic-ischemic encephalopathy,brain injury in preterm infants,and intracranial hemorrhage,but the secondary factors causing infantile spasms have not yet been fully elucidated.Previous studies on the relationship between hypoglycemic brain injury and infantile spasms suggest that hypoglycemic brain injury may be associated with infantile spasms to some extent,but research in this area is rarely reported at home and abroad.We analyzed the etiology of infants with infantile spasms in our previous diagnosis and found that the proportion of infantile spasms secondary to hypoglycemic brain injury almost exceeded that of hypoxic-ischemic encephalopathy.This study was designed to pass the hypoglycemic brain injury secondary to The clinical data of children with infantile spasms were analyzed,the results of the odds ratio and other related statistics.(The odds ratio,also known as the odds ratio or the cross product ratio,is an indicator that analyzes the degree of connection between disease and exposure factors).To explore the association between hypoglycemic brain injury and infantile spasms.ObjectiveThis study intends to retrospectively analyze the clinical data of infantile spasms secondary to hypoglycemic brain injury,and analyzes the therapeutic effects and follow-up to explore: 1.The relationship between hypoglycemic brain injury and infantile spasms;2.Compared with the previous studies on the curative effect of infantile spasms in this group,we observed the therapeutic effects of infantile spasms with a history of hypoglycemic brain injury.MethodsCollected 183 children with infantile spasms diagnosed at the Third Affiliated Hospital of Zhengzhou University from July 2013 to January 2017 as the observation group,and their clinical,EEG and imaging data were analyzed and statistically analyzed,among these,39 were diagnosed with infantile spasms and early can be traced back to the history of hypoglycemia brain injury;a total of 183 children with non-infantile spasms were enrolled as a control in the same period,there were 17 cases with hypoglycemic brain injury and 166 cases without hypoglycemic brain injury,and the statistical analysis was performed.Data analysis SPSS 21.0 software was used for descriptive statistics of the two groups of clinical data.Experimental data are expressed as median,mean ± standard deviation(±s).Statistical analysis was performed using single independent logistic regression analysis.P<0.5 was considered statistically significant.Result1.The observed group of 183 cases of infantile spasms in children with a history of hypoglycemic brain injury in 39 cases,accounting for 21% of the observation group,the control group has a history of hypoglycemic brain injury in 17 cases,the two groups of data from a single Logistic regression analysis showed that the correlation coefficient between hypoglycemic brain injury and infantile spasms has an OR of 2.645,P<0.05,the difference was statistically significant,suggesting that hypoglycemic brain injury was positively correlated with infantile spasms.2.The incidence of hypoglycemia in 39 infants with hypoglycemic brain injury in the observation group was 2.69±1.40 days after birth,and the blood glucose level was 1.10±0.52 mmol/L.74.36% of the infants had clear imaging findings.The parietal occipital lobe softened or glial hyperplasia,controlled by methylprednisolone combined with other antiepileptic drugs in June,the control rate was 7.69%.Conclusion1.Hypoglycemia Brain injury is a risk factor for infantile spasms;2.Infant spasms that caused by hypoglycemia brain damage have low control rates and poor prognosis.