小儿急性脑炎的病因,诊断挑战和预后因素的变化:从一项为期18年的回顾性研究的见解
Lorna Stemberger Marić1,2, Dominik Ljubas3, Andrea Nikčević3
1School of Medicine, University of Zagreb, Šalata 3, Zagreb, 10 000, Croatia. lmaric@bfm.hr.
概括
儿童急性脑炎病例往往缺乏确定的原因,免疫媒介疾病的增加. 优先考虑神经影像辅助诊断和预后,以获得患有脑炎的儿童更好的治疗结果.
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:
- 在儿科患者中,未确定的急性脑炎的高发病率仍然存在.
- 全球范围内正在出现新的脑炎致病原体.
- 这项研究检查了儿科急性脑炎的特征和继发症的危险因素.
研究的目的:
- 调查儿科急性脑炎病例的特征.
- 评估诊断改进对病因学确定的影响.
- 确定与儿科脑炎的后果相关的危险因素.
主要方法:
- 从2006年到2023年对235例儿科急性脑炎病例 (0-18岁) 的分析.
- 已知病因与未知病因,传染病与非传染病因之间的特征比较.
- 评估与出院时神经系统后果相关的因素.
主要成果:
- 病因在62.1%的病例中被确定;急性传播性脑膜炎是最常见的 (44.2%).
- 已知病因的患者住院时间较长,MRI异常和后果的发生率更高.
- 年龄较小,MRI异常,非传染性病因,以及高CSF蛋白预测后果.
结论:
- 免疫媒介性脑炎在儿童群体中正在增加.
- 病因学检测率仍然低于最佳水平,尽管诊断方面取得了进展.
- 优先考虑神经放射学评估可以改善儿科脑炎的诊断和预后.
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