预测发烧性感染相关综合征 (FIRES) 的长期结果的标准完整血清:多中心研究
Martin Guillemaud1, Aurélie Hanin1,2,3,4, James J Riviello5
1Institut du Cerveau, Paris Brain Institute, ICM, INRIA, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Epilepsia
|August 22, 2025
概括
完整血清 (CBC) 分析可以预测患有密码性发烧感染相关综合征 (FIRES) 的患者的结果. 特定的CBC标志物如中性粒细胞与淋巴细胞的比率和红细胞分布宽度显示为早期预后有前途.
科学领域:
- 神经学
- 血液学
- 儿童医学
背景情况:
- 密码性发烧性感染相关综合征 (FIRES) 是一种严重的新发性耐火性状态 (NORSE).
- 预测FIRES患者的长期结果对于治疗规划和管理至关重要.
- 全血细胞计 (CBC) 是一个易于使用的实验室检测.
研究的目的:
- 调查密码性FIRES患者在重症监护室 (ICU) 停留期间的全血细胞计 (CBC) 分析的预测价值.
- 确定可预测FIRES成人和儿童结果的特定CBC参数.
主要方法:
- 一项回顾性研究分析了63名患有密码性FIRES的患者 (34名成年人,29名儿童) 的连续CBC数据.
- 在12个月后的结果被归类为有利的 (格拉斯哥结果得分 [GOS] 4-5) 或不利的 (GOS 1-3).
- 使用决策树回归模型根据CBC特征对结果进行分层,对成人和儿童进行单独的模型测试,采用离开一个患者的方法.
主要成果:
- 在18名成人和12名儿童中观察到不良结果.
- 结果不佳的成年人中,中性细胞与淋巴细胞的比率 (NLR) 和单细胞与淋巴细胞的比率 (MLR) 较高.
- 结果不佳的儿童的红细胞分布幅度更大;儿童的预测准确度比成年人 (83%) 高.
结论:
- 完整血清 (CBC) 分析显示了密码性FIRES早期预后的快速和可访问的工具的潜力.
- 特定的CBC参数,包括NLR,MLR和红细胞分布宽度,可以帮助预测12个月的结果.
- 这些发现对儿童FIRES病例的预后尤为有希望.
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