儿童脑疟疾中的大脑代谢危机
Nicole F O'Brien1, Karen Chetcuti2, Yudy Fonseca3
1Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, United States.
Journal of pediatric intensive care
|November 16, 2023
概括
大脑代谢能量危机 (CMEC) 在患有大脑疟疾 (CM) 的儿童中很常见,超过一半的儿童患有缺血性CMEC. 这种亚型与较差的脑血流和较差的神经结果有关,这表明潜在的治疗点.
科学领域:
- 神经学 神经学
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
背景情况:
- 大脑代谢能量危机 (CMEC),通过高的脑脊液 (CSF) 乳酸:酸盐比率 (LPR) 表示,与神经学结果差相关.
- 脑疟疾 (CM) 是全球儿童死亡率和神经障碍的主要原因.
- 儿童CM患者中CMEC的发生和特征仍未得到充分研究.
研究的目的:
- 为了确定CMEC在CM的儿童中的频率.
- 要区分缺血性和非缺血性CMEC亚型.
- 调查CMEC亚型与大脑血流以及神经结果之间的关联.
主要方法:
- 53名被诊断患有CM的儿童被纳入该研究.
- 分析了CSF乳酸和酸盐水平,以计算LPR.
- 经骨多普勒超声波用于评估大脑血液流动速度.
主要成果:
- 所有53名儿科CM患者均表现出CMEC,中位数CSFLPR为72.9.9.
- 一半的患者被归类为缺血性CMEC (LPR中位数85) 和一半的非缺血性CMEC (LPR中位数60).
- 缺血性CMEC与非缺血性CMEC相比,大脑血流低或血管率显著更高 (73%vs. 20%) 和神经结果较差 (46%vs. 22%).
结论:
- 在儿科大脑疟疾中,CMEC是一种几乎普遍的发现.
- 缺血性和非缺血性CMEC亚型与大脑血液动力学和神经结果有明显的关联.
- 针对这些CMEC亚型的潜在机制,可能为儿科CM的新增辅助疗法提供途径.
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