与PANS症状持续性相关的因素:第I部分-获得护理的机会
Denise Calaprice-Whitty1,2, Angela Tang1, Janice Tona3
1Division of Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
Journal of child and adolescent psychopharmacology
|October 30, 2023
概括
及时获得专家护理可以显著改善患有儿科急性发作神经精神综合征 (PANS) 的儿童的结果. 像延迟诊断和治疗负担能力这样的障碍与持续的症状和更糟糕的疾病进程有关.
科学领域:
- 儿科神经学 儿科神经学
- 免疫学 免疫学 免疫学
- 临床结果研究研究的临床结果.
背景情况:
- 儿科急性发病神经精神综合征 (PANS) 具有突发的神经精神症状的特征,通常是由免疫事件引发的.
- 以前的研究表明,诊断延迟与PANS症状复发的增加有关.
- 这项研究调查了护理障碍如何影响PANS症状的持续性.
研究的目的:
- 分析儿童急性发病神经精神综合征 (PANS) 中获得护理障碍和症状持续性之间的关联.
- 确定特定的挑战,如诊断延迟,缺乏专家访问和负担能力,影响PANS患者的结果.
- 探索PANS的初始治疗有效性和长期症状过程之间的关系.
主要方法:
- 来自一项146个问题的在线调查数据的二次分析,由646名患有PANS的受试者完成.
- 多变量分析检查了与获得护理史有关的症状持久性 (超过4年的无症状日%) .
- 评估的关键因素包括治疗的时间,医疗专业知识的可用性,负担能力和最初的抗生素有效性.
主要成果:
- 症状发作和治疗之间的较长间隔显著与症状持续时间更长相关 (p=0.002).
- 缺乏专业知识和负担能力的问题在持久PANS症状的受试者中更为普遍.
- 诱发性感染的成功抗生素治疗与较少的症状持久性相关 (p=0.0001).
结论:
- 无障碍地及时获得专家护理对于改善PANS患者无症状期至关重要.
- 难以接触专家,诊断延迟和财务限制可能会对PANS结果产生负面影响.
- 建议卫生保健提供者,特别是初级保健医生遵守诊断和治疗指南,以便及时管理PANS.
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