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皮质类固醇在非细菌性和继发性脑炎中的作用

The Role of Corticosteroids in Non-Bacterial and Secondary Encephalitis.

作者信息

Di Flumeri Giusy, Giaccari Luca Gregorio, Pace Maria Caterina, Passavanti Maria Beatrice, Pota Vincenzo, Riccardi Vincenzo, Brunetti Simona, Sansone Pasquale, Coppolino Francesco, Aurilio Caterina

机构信息

UOC Emerging Infectious Disease with High Contagiousness, AORN Ospedali dei Colli P.O. C Cotugno, 80131 Naples, Italy.

Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80134 Naples, Italy.

出版信息

Life (Basel). 2024 Dec 22;14(12):1699. doi: 10.3390/life14121699.

Abstract

Encephalitis affects 1.9 to 14.3 people per 100,000 each year, and the mortality rate varies but can be up to 40%. After the identification of a particular microorganism in a patient with encephalitis, appropriate antimicrobial therapy should be initiated. Corticosteroid therapy represents a therapeutic option in the treatment of primary central nervous system diseases due to its ability to reduce the inflammatory commitment of CNS and consequently reduce mortality rates regardless of the causative agent of injury. Corticosteroid therapy represents a therapeutic option in the treatment of primary central nervous system diseases. Their use is also recommended in meningitis with autoimmune etiology. While corticosteroids have repeatedly been used as adjunctive treatment in encephalitis of viral etiology, the scientific evidence supporting their effectiveness remains scarce. The use of standard doses recommended by the guidelines seems reasonable as an initial setting, especially when a definitive diagnosis of the causal agent is still awaited. The subsequent adjustment should be personalized based on the individual clinical response.

摘要

脑炎每年每10万人中有1.9至14.3人受影响,死亡率各不相同,但可达40%。在脑炎患者中鉴定出特定微生物后,应开始适当的抗菌治疗。皮质类固醇疗法是治疗原发性中枢神经系统疾病的一种治疗选择,因为它能够减少中枢神经系统的炎症反应,从而降低死亡率,而不论损伤的病原体是什么。皮质类固醇疗法是治疗原发性中枢神经系统疾病的一种治疗选择。在自身免疫性病因的脑膜炎中也建议使用。虽然皮质类固醇已多次被用作病毒性病因脑炎的辅助治疗,但支持其有效性的科学证据仍然很少。作为初始设置,使用指南推荐的标准剂量似乎是合理的,特别是在仍等待明确病因诊断时。随后的调整应根据个体临床反应进行个性化处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec2/11679550/6bf99fb93d3f/life-14-01699-g001.jpg

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