Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Brain Dev. 2020 Aug;42(7):508-514. doi: 10.1016/j.braindev.2020.04.006. Epub 2020 Apr 22.
We previously reported the nationwide, epidemiological data of acute encephalopathy in Japan during 2007-2010. Here we conducted the second national survey of acute encephalopathy during 2014-2017, and compared the results between the two studies to elucidate the trends in the seven years' interval as well as the influence of changes in pediatric viral infections and guidelines for acute encephalopathy in Japan.
The Research Committee on Acute Encephalopathy supported by the Japanese Government sent a questionnaire to 507 hospitals throughout Japan, and collected the responses by mail.
A total of 1115 cases from 267 hospitals reportedly had acute encephalopathy during April 2014-June 2017. In this study, the age at onset was younger, the ratios of recently established syndromes, such as acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS), were higher, and the ratio of influenza-associated encephalopathy was lower, than in the previous study. The age at onset of influenza-associated encephalopathy was lower, and that of HHV-6/7-associated encephalopathy higher, compared to the first survey. The outcomes of entire acute encephalopathy remained unchanged.
Some of these changes reflected the recent trends of viral infectious diseases including 2009 influenza pandemic, and others the standardization of the diagnosis of acute encephalopathy in Japan.
我们之前报道了 2007-2010 年日本急性脑病的全国性流行病学数据。在此，我们进行了 2014-2017 年的第二次全国性急性脑病调查，并将两项研究的结果进行了比较，以阐明这七年间隔的趋势以及日本小儿病毒感染和急性脑病指南变化的影响。
由日本政府支持的急性脑病研究委员会向日本各地的 507 家医院发送了一份问卷，并通过邮件收集了回复。
共有 267 家医院的 1115 例报告称在 2014 年 4 月至 2017 年 6 月期间患有急性脑病。在本研究中，发病年龄更小，近期新出现的综合征（如急性脑病伴双相抽搐和晚期弥散减少（AESD）和临床轻度脑炎/脑病伴可逆性胼胝体病变（MERS））的比例更高，而流感相关性脑病的比例更低与前一项研究相比。流感相关性脑病的发病年龄更低，HHV-6/7 相关性脑病的发病年龄更高，与第一项调查相比。急性脑病的整体预后保持不变。
这些变化的部分原因是包括 2009 年流感大流行在内的病毒性传染病的近期趋势，另一些原因是日本急性脑病诊断的标准化。
