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急性脑炎综合征患儿的日本脑炎临床特征及转归

Clinical profile and outcome of Japanese encephalitis in children admitted with acute encephalitis syndrome.

作者信息

Kakoti Gitali, Dutta Prafulla, Ram Das Bishnu, Borah Jani, Mahanta Jagadish

机构信息

Regional Medical Research Centre, ICMR, Northeast Region, P.O. Box No. 105, Dibrugarh, Assam 786 001, India.

Department of Community Medicine, Assam Medical College, Dibrugarh Assam 786002, India.

出版信息

Biomed Res Int. 2013;2013:152656. doi: 10.1155/2013/152656. Epub 2013 Dec 29.

Abstract

Japanese encephalitis (JE) is an arthropod borne viral disease. Children are most commonly affected in Southeast Asian region showing symptoms of central nervous system with several complications and death. The clinical characteristics and outcomes in pediatric JE patients hospitalized with acute encephalitis syndrome (AES) are still poorly understood. A prospective study was conducted in pediatric ward of Assam Medical College Hospital to evaluate the clinical profile and outcome of JE in children. A total of 223 hospitalized AES cases were enrolled during March to December 2012. Serum and cerebro spinal fluids were tested for presence of JE specific IgM antibody. 67 (30%) were found to be JE positive. The most common presenting symptoms in JE patients were fever (100%), altered sensorium (83.58%), seizure (82.08%), headache (41.79%), and vomiting (29.85%). Signs of meningeal irritation were present in 55.22% of cases. Around 40.29%, JE patients had GCS ≤ 8. Among the JE patients, 14.7% died before discharge. The complete recoveries were observed in 63.9% of cases, while 21.3% had some sort of disability at the time of discharge. JE is still a major cause of AES in children in this part of India. These significant findings thus seek attentions of the global community to combat JE in children.

摘要

日本脑炎(JE)是一种节肢动物传播的病毒性疾病。在东南亚地区,儿童最常受到影响,表现出中枢神经系统症状,并伴有多种并发症和死亡。对于因急性脑炎综合征(AES)住院的小儿JE患者的临床特征和预后仍知之甚少。在阿萨姆医学院医院的儿科病房进行了一项前瞻性研究,以评估儿童JE的临床特征和预后。2012年3月至12月期间,共纳入223例住院的AES病例。检测血清和脑脊液中JE特异性IgM抗体的存在情况。发现67例(30%)为JE阳性。JE患者最常见的症状为发热(100%)、意识改变(83.58%)、癫痫发作(82.08%)、头痛(41.79%)和呕吐(29.85%)。55.22%的病例有脑膜刺激征。约40.29%的JE患者格拉斯哥昏迷评分(GCS)≤8。在JE患者中,14.7%在出院前死亡。63.9%的病例完全康复,而21.3%在出院时有某种残疾。在印度的这一地区,JE仍然是儿童AES的主要病因。因此,这些重要发现需要全球社会关注儿童JE的防治。

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