中文摘要：

目的探讨血清特异性烯醇化酶（NSE）、脑电图（EEG）、颅脑磁共振成像（MRI）对病毒性脑炎合并惊厥患儿预后的评估价值。方法收集2008年1月—2012年12月潍坊市人民医院住院确诊为病毒性脑炎合并惊厥的患儿65例，于病程3d内同期进行血清NSE、EEG、颅脑MRI检查，详细记录临床资料，对检查异常患儿分组为NSE异常组、EEG异常组、MRI异常组，伴有昏迷、局灶体征为重症，记录3组患儿重症发生率；治疗后2周～3个月进行1～3次复查，3个月时记录3组患儿恢复正常率；临床随访半年，对患儿神经功能进行评估，记录3组患儿神经系统后遗症发生率。采用单因素和多因素Logistic回归法分析影响患儿预后的因素。结果65例患儿NSE异常43例（66．2％），EEG异常58例（89．2％），MRI异常36例（55．4％）。NSE、EEG、MRI异常患儿重症发生率、恢复正常率、后遗症发生率比较，差异均有统计学意义（P〈0．05）；其中MRI异常组重症发生率高于EEG异常组（P〈0．01）；EEG、NSE异常组恢复正常率均高于MRI异常组（P〈0．01）；MRI异常组后遗症发生率高于EEG异常组（P〈0．01）。单因素Logistic回归分析结果显示，NSE异常、EEG异常、MRI异常及合并多脏器损伤对病毒性脑炎合并惊厥患儿的预后有影响（P〈0．05）。多因素Logistic回归分析结果显示，NSE异常、MRI异常及合并多脏器损伤为病毒性脑炎合并惊厥患儿预后不良的危险因素（P〈0．05）。结论血清NSE、EEG、MRI是病毒性脑炎合并惊厥患儿重要辅助检查方法，NSE、MRI异常者预后不良，MRl对预后判断价值最大。三若从不同角度反映脑损伤情况，结合分析、动态观察对正确诊断、判断病情、治疗效果及预后评估有重要意义，为患儿恢复期进行早期康复治疗以改善预后提供了有价值的临床依据。

英文摘要：

Objective To explore the prognostic value of serum neuron specific enolase （NSE） , electroencephalo- gram （EEG） and brain magnetic resonance imaging （MRI） for children with viral encephalitis combined with convul- sion. Methods 65 children diagnosed as viral encephalitis combined with convtdsion admitted to the People＇s Hospital of Weifang form January 2008 to December 2012 were involved into the study. According to the results of serum NSE, EEG and brain MRI, the children were divided into abnormal NSE group, abnormal EEG group and abnormal MRI group. The children with coma and focal signs were defined as severe cases. The rate of severe case, the recovery rate alter three months and the sequela rate of nerv- ous system after six months were recorded and the factors influencing prognosis were analyzed by univariate and multivariate Logis- tic regression analysis. Results Among the 65 children, 43 cases had abnormal NSE （66. 2% ） , 58 cases had abnormal EEG （89. 2% ） and 36 cases had abnormal MRI （55.4%） . The severe case rate, recovery rate and sequela rate of the three groups all showed statistically significant differences （ P 〈 0. 05 ） . The severe case rate in abnormal MRI group was higher than the ab- normal EEG group （ P 〈 0. 01 ） . The recovery rate in abnormal EEG group and abnormal NSE group was higher than abnormal MRI group （ P 〈 0. 01 ） . The sequela rate in abnormal MRI group was higher than abnormal EEG group （ P 〈 0. 01 ） . Univariate Logistic analysis showed that abnormal NSE, EEG, MRI and the combination with multiple organ damage could influence the prognosis of children with viral encephalitis combined with convulsion （P 〈0. 05） . Multivariate Logistic analysis showed that ab- normal NSE, MRI and the combination of muhiple organ damage are risk factors for bad prognosis （ P 〈 O. 05 ） . Conclusion Serum NSE, EEG and brain MRI are important auxiliary examination methods for children with viral encephalitis and convulsion, among which