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目的探究儿童晕厥和惊厥的临床初步鉴别方法,为临床及时诊断提供依据。方法选取2013年1月至2015年12月于门诊接受诊治的惊厥或晕厥儿童164例,其中惊厥儿童77例,晕厥儿童87例。分别采用Calgary晕厥惊厥评分(CSSS)量表及Calgary晕厥惊厥改良评分(MCSSS)量表对所有患儿进行评定,并使用受试者工作特征(ROC)曲线评定CSSS和MCSSS对检测儿童惊厥或晕厥的灵敏度和特异度。结果晕厥儿童CSSS评分均值为(-4.12±1.13)分,惊厥儿童CSSS均值为(2.54±0.78)分;晕厥儿童MCSSS均值为(-4.47±0.96)分,惊厥儿童MCSSS均值为(3.41±1.04)分,同一组中CSSS和MCSSS两种评分间比较无统计学差异(P均>0.05),但晕厥和惊厥两组间相同评分比较差异均有统计学意义(P均<0.05)。CSSS组ROC曲线显示:以CSSS≥1为界值对儿童惊厥和晕厥鉴定的灵敏度为91.46%,特异度为95.80%,Youden指数为0.87,CSSS评分≥1分可能为惊厥。MCSSS组ROC曲线显示以MCSSS≥1为界值鉴定儿童惊厥或晕厥的灵敏度为92.68%,特异度为96.64%,Youden指数为0.89,MCSSS评分≥1分可能为惊厥。两种评分之间有些许差异,MCSSS对于检测惊厥或晕厥的灵敏度和特异度要稍高于CSSS,但两者之间差异无统计学意义(P均>0.05)。结论 CSSS和MCSSS对于临床初步鉴定儿童惊厥或儿童晕厥效果明显,可作为临床鉴定儿童惊厥或晕厥的初步依据。
Objective To explore the clinical preliminary identification method of syncope and convulsion in children and provide the basis for clinical diagnosis in time. Methods A total of 164 convulsions or syncope children were selected from outpatients from January 2013 to December 2015, including 77 convulsions and 87 syncope children. All children were assessed using the Calgary Syncope Scress (CSSS) scale and the Calgary Syncope Convulsion Improvement Score (MCSSS) scale, and CSS and MCSSS were assessed using the receiver operating characteristic (ROC) curve for the detection of children with convulsions or syncope Sensitivity and specificity. Results The CSSS score was (-4.12 ± 1.13) in children with syncope and (2.54 ± 0.78) in children with convulsion. The mean MCSSS was (-4.47 ± 0.96) in children with syncope and (3.41 ± 1.04) in children with convulsion. There was no significant difference between the two groups in CSSS and MCSSS scores (P> 0.05) in the same group, but there was significant difference between the two groups in syncope and convulsion (P <0.05). The ROC curve of CSSS group showed that the sensitivity of children with seizure and syncope was 91.46%, the specificity was 95.80%, the Youden index was 0.87 and the CSSS≥1 was the convulsion. The ROC curve of MCSSS group showed that the sensitivity, sensitivity and specificity of 92.68%, 96.64%, Youden index and MCSSS score of ≥1 for children with MCSSS ≥ 1 as the cut-off points were considered as convulsions. There was a slight difference between the two scores. The sensitivity and specificity of MCSSS for detecting convulsions or syncope were slightly higher than that of CSSS, but there was no significant difference between the two (P> 0.05). Conclusions CSSS and MCSSS are effective in initially identifying children with convulsions or children with syncope. They can be used as a preliminary basis for clinical identification of children with convulsions or syncope.