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神经系统疾病家系的回顾性数据分析。

The retrospective data analysis on the pedigree of nervous system diseases in children.

机构信息

School of Statistics and Data Science, Jiangxi University of Finance and Economics, Nanchang, 330013, China.

Department of Neurology, Hunan Children's Hospital, Changsha, China.

出版信息

Sci Rep. 2023 Jul 5;13(1):10847. doi: 10.1038/s41598-023-35571-0.

Abstract

Nowadays, the development of diagnosis and treatment technology is constantly changing the pedigree and classification of nervous system diseases. Analyzing changes in earlier disease pedigrees can help us understand the changes involved in disease diagnosis from a macro perspective, as well as predict changes in later disease pedigrees and the direction of diagnosis and treatment. The inpatients of the neurology department from January 2012 to December 2020 in Hunan Children's Hospital were retrospectively analyzed. There were 36,777 patients enrolled in this study. The next analysis was based on factors like age, gender, length of stay (LoS), number of patients per month and per year (MNoP and ANoP, respectively), and average daily hospital cost (ADHE). To evaluate the characteristics of neurological diseases, we applied a series of statistical tools such as numerical characteristics, boxplots, density charts, one-way ANOVA, Kruskal-Wallis tests, time-series plots, and seasonally adjusted indices. The statistical analysis of neurological diseases led to the following conclusions: First, children having neurological illnesses are most likely to develop them between the ages of 4 and 8 years. Benign intracranial hypertension was the youngest mean age of onset among the various neurologic diseases, and most patients with bacterial intracranial infection were young children. Some diseases have a similar mean age of onset, such as seizures (gastroenteritis/diarrhea) and febrile convulsions. Second, women made up most patients with autoimmune diseases of the central nervous system. Treatment options for inherited metabolic encephalopathy and epilepsy are similar, but they differ significantly for viral intracranial infection. Some neurologic diseases were found to have seasonal variations; for example, infectious diseases of the central nervous system were shown to occur more commonly in the warm season, whereas, autoimmune diseases primarily appeared in the autumn and winter months. Additionally, the number of patients admitted to hospitals with intracranial infections and encephalopathy has dramatically dropped recently, but the number of patients with autoimmune diseases of the central nervous system and hereditary metabolic encephalopathy has been rising year over year. Finally, we discovered apparent polycentric distributions in various illnesses' density distributions. The study offered an epidemiological basis for common nervous system diseases, including evidence from age of onset, number of cases, and so on. The pedigree of nervous system diseases has significantly changed. The proportion of patients with neuroimmune diseases and genetic metabolic diseases is rising while the number of patients with infection-related diseases and uncertain diagnoses is decreasing. The existence of a disease multimodal model suggests that there is still a lack of understanding of many diseases' diagnosis and treatment, which needs to be improved further because accurate diagnosis aids in the formulation of individualized treatment plans and the allocation of medical resources; additionally, there is still a lack of effective treatment for most genetic diseases. The seasonal characteristics of nervous system diseases suggest the need for the improvement of sanitation, living conditions, and awareness of daily health care.

摘要

现如今,诊断和治疗技术的发展不断改变神经系统疾病的谱系和分类。分析早期疾病谱系的变化可以帮助我们从宏观角度了解疾病诊断所涉及的变化,并预测后期疾病谱系的变化和诊断治疗的方向。本研究回顾性分析了 2012 年 1 月至 2020 年 12 月在湖南省儿童医院神经内科住院的患者。共纳入 36777 例患者。后续分析基于年龄、性别、住院时间(LoS)、每月和每年的患者人数(MNoP 和 ANoP)以及平均每日住院费用(ADHE)等因素。为了评估神经系统疾病的特征,我们应用了一系列统计工具,如数值特征、箱线图、密度图、单因素方差分析、克鲁斯卡尔-沃利斯检验、时间序列图和季节性调整指数。神经系统疾病的统计分析得出以下结论:首先,患有神经系统疾病的儿童最有可能在 4 至 8 岁之间发病。良性颅内高压是各种神经系统疾病中发病年龄最小的,大多数细菌性颅内感染的患者是幼儿。一些疾病的发病年龄相似,如癫痫(胃肠炎/腹泻)和热性惊厥。其次,女性是中枢神经系统自身免疫性疾病患者的大多数。遗传性代谢性脑病和癫痫的治疗选择相似,但病毒性颅内感染的治疗选择则明显不同。一些神经系统疾病具有季节性变化;例如,中枢神经系统感染性疾病在温暖季节更为常见,而自身免疫性疾病主要出现在秋冬季节。此外,最近颅内感染和脑病住院患者数量急剧下降,但中枢神经系统自身免疫性疾病和遗传性代谢性脑病患者数量逐年增加。最后,我们发现各种疾病的密度分布存在明显的多中心分布。该研究为常见神经系统疾病提供了流行病学基础,包括发病年龄、病例数等证据。神经系统疾病的谱系发生了显著变化。神经免疫性疾病和遗传代谢性疾病的比例正在上升,而感染性疾病和不确定诊断的比例正在下降。疾病多模态模型的存在表明,我们对许多疾病的诊断和治疗仍缺乏了解,这需要进一步改进,因为准确的诊断有助于制定个体化的治疗计划和分配医疗资源;此外,大多数遗传疾病仍然缺乏有效的治疗方法。神经系统疾病的季节性特征表明需要改善卫生条件、生活条件和日常保健意识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ab8/10322957/e4d14bd64fdf/41598_2023_35571_Fig1_HTML.jpg

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