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农村儿童乙型脑炎与急性脑炎综合征临床特征和结局比较。

Comparison of Clinical Profile and Outcomes of Japanese Encephalitis and Acute Encephalitis Syndrome among Rural Children.

机构信息

Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram, Wardha, Maharashtra, 442102, India.

All India Institute of Medical Sciences, Bibinagar, Telangana, India.

出版信息

Indian J Pediatr. 2023 Oct;90(10):1038-1040. doi: 10.1007/s12098-022-04424-5. Epub 2023 Feb 11.

Abstract

The study compared the clinical profile and outcomes of Japanese encephalitis (JE) and acute encephalitis syndrome (AES) in children. Fifty-six consecutive children with symptoms fulfilling the WHO clinical case definition of AES from June 2018 to June 2020 were included in the study. All patients who tested positive for either serum or cerebrospinal fluid (CSF) anti-JE-IgM antibodies were JE patients (n = 24) and compared with non-JE AES cases (n = 32). Fever, seizures, and altered sensorium were the most common presenting symptoms. Low GCS, status epilepticus, meningeal irritation, raised CSF protein, and INR > 1.5 of JE children showed significant association with mortality (p value < 0.05), whereas only low GCS showed significant association in non-JE AES cases. The JE-specific mortality rate was 29%, which was less than the mortality rate of non-JE AES children at 41%. Both JE and non-JE AES children had a similar clinical profile, but only the JE children's poor clinical and laboratory parameters were associated with adverse outcomes.

摘要

本研究比较了日本脑炎(JE)和急性脑炎综合征(AES)在儿童中的临床特征和结局。纳入了 2018 年 6 月至 2020 年 6 月期间符合世界卫生组织 AES 临床病例定义的 56 例连续出现症状的儿童。所有血清或脑脊液(CSF)抗-JE-IgM 抗体检测阳性的患者均为 JE 患者(n=24),并与非 JE AES 病例(n=32)进行比较。发热、癫痫发作和意识改变是最常见的首发症状。低格拉斯哥昏迷量表(GCS)评分、癫痫持续状态、脑膜刺激征、CSF 蛋白升高和 INR>1.5 与 JE 患儿的死亡率显著相关(p 值<0.05),而非 JE AES 病例中仅低 GCS 评分与死亡率显著相关。JE 的特定死亡率为 29%,低于非 JE AES 患儿的 41%。JE 和非 JE AES 患儿的临床特征相似,但只有 JE 患儿的临床和实验室参数较差与不良结局相关。

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