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人类副肠孤病毒脑膜炎与幼儿粗大运动神经发育不良

Human parechovirus meningitis and gross-motor neurodevelopment in young children.

机构信息

Department of Pediatrics, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 LC, Tilburg, the Netherlands.

Department of Pediatric, Bravis Hospital, Boerhaaveplein 1, 4624 VT, Bergen op Zoom, the Netherlands.

出版信息

Eur J Pediatr. 2019 Apr;178(4):473-481. doi: 10.1007/s00431-019-03319-6. Epub 2019 Jan 14.

Abstract

This multicenter prospective cohort study describes the impact of human parechovirus meningitis on gross-motor neurodevelopment of young children. Gross-motor function was measured using Alberta Infant Motor Scale. Of a total of 38 eligible children < 10 months of age at onset, nine cases had clinical evidence of meningitis and polymerase chain reaction positive for human parechovirus in cerebrospinal fluid; 11 had no meningitis and polymerase chain reaction positive for human parechovirus in nasopharyngeal aspirate, blood, urine, or feces; and in 18, no pathogen was identified (reference group).The children with human parechovirus meningitis showed more frequent albeit not statistically significant suspect gross-motor function delay (mean Z-score (standard deviation) - 1.69 (1.05)) than children with human parechovirus infection-elsewhere (- 1.38 (1.51)). The reference group did not fall in the range of suspect gross-motor function delay (- 0.96 (1.07)). Adjustment for age at onset and maternal education did not alter the results.Conclusion: Six months after infection, children with human parechovirus meningitis showed more frequent albeit not statistically significant suspect gross-motor function delay compared to the population norm and other two groups. Longitudinal studies in larger samples and longer follow-up periods are needed to confirm the impact and persistence of human parechovirus meningitis on neurodevelopment in young children. What is Known: • Human parechovirus is progressively becoming a major viral cause of meningitis in children. • There is keen interest in the development of affected infants with human parechovirus meningitis. What is New: • This study describes prospectively gross-motor functional delay in children with both clinical evidence of meningitis and polymerase chain reaction positive for human parechovirus in cerebrospinal fluid. • It shows the importance of screening young children for developmental delay in order to refer those with delay for early intervention to maximize their developmental potential.

摘要

这项多中心前瞻性队列研究描述了人类肠道病毒脑膜炎对幼儿粗大运动神经发育的影响。粗大运动功能使用 Alberta 婴儿运动量表进行测量。在总共 38 名发病时年龄<10 个月的符合条件的儿童中,9 例有临床证据的脑膜炎和脑脊液中聚合酶链反应阳性的人类肠道病毒;11 例无脑膜炎和鼻咽抽吸物、血液、尿液或粪便中聚合酶链反应阳性的人类肠道病毒;18 例未确定病原体(参考组)。患有人类肠道病毒脑膜炎的儿童表现出更频繁但无统计学意义的可疑粗大运动功能延迟(平均 Z 评分(标准差)-1.69(1.05)),而在其他部位感染人类肠道病毒的儿童中(-1.38(1.51))。参考组未落入可疑粗大运动功能延迟的范围(-0.96(1.07))。调整发病年龄和母亲教育程度并未改变结果。结论:感染后 6 个月,与人群正常值和其他两组相比,患有人类肠道病毒脑膜炎的儿童表现出更频繁但无统计学意义的可疑粗大运动功能延迟。需要在更大样本量和更长随访期的纵向研究中证实人类肠道病毒脑膜炎对幼儿神经发育的影响和持续性。已知:• 人类肠道病毒逐渐成为儿童脑膜炎的主要病毒病因。• 人们对患有人类肠道病毒脑膜炎的婴儿的发育状况非常关注。新发现:• 本研究前瞻性地描述了临床证据表明患有脑膜炎和脑脊液中聚合酶链反应阳性的人类肠道病毒的儿童的粗大运动功能延迟。• 它表明了对发育迟缓的幼儿进行筛查的重要性,以便将那些有发育迟缓的幼儿转介给早期干预,以最大限度地发挥他们的发育潜力。

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