我们可以预测单纯疹和疹子脑炎的不良结果吗? 一个叙事审查
Lena S Abbuehl1, Eveline Hofmann2, Arsany Hakim3
1Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Frontiers in neurology
|July 12, 2023
概括
简单疹病毒 (HSV) 和疹病毒 (VZV) 脑炎的死亡率很高,尽管有治疗. 预后因素包括年龄,并发症,疾病严重程度,MRI病变和延迟治疗,需要标准化研究以获得更好的结果.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 简单疹病毒 (HSV) 和疹病毒 (VZV) 是全球传染性脑炎的主要原因.
- 即使在治疗中,高死亡率和发病率仍然存在,特别是HSV脑炎.
- 关于继续或停止治疗的临床决策是具有挑战性的,因为结果是可变的.
研究的目的:
- 审查有关HSV和VZV脑炎结局现有文献.
- 确定影响患者结果的预后因素.
- 突出当前研究的局限性,并建议未来的方向.
主要方法:
- 在两个数据库中进行了文献综述.
- 包括55项研究,调查HSV/VZV脑炎的结果和预测参数.
- 数据提取和叙事总结由两个独立的审稿人进行.
主要成果:
- 无论是HSV还是VZV脑炎,死亡率都在5%到20%之间.
- 完全康复率为HSV的14-43%和VZV脑炎的33-49%.
- 预测因素包括年龄,并发症,疾病严重程度,MRI病变范围和延迟的HSV治疗.
结论:
- 不一致的患者选择,病例定义和结果措施限制了当前研究的可比性.
- 需要更大的,标准化的观测研究,具有验证的措施.
- 需要更好的证据来指导临床决策,并加强对HSV和VZV脑炎的患者护理.
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