新型冠状病毒感染相关脑炎4例临床特点及文献复习  

Clinical characteristics and literature review of 4 cases of SARS‑CoV‑2 infection⁃associated encephalitis

作　　者：彭彬[1] 刘娜[1] 解燕春[1] 曹倩[1] 吴旭[1] 董红娟[1] 潘松青[1] PENG Bin;LIU Na;XIE Yanchun;CAO Qian;WU Xu;DONG Hongjuan;PAN Songqing(Dept.of Neurology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院神经内科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2024年第8期1010-1016,共7页Medical Journal of Wuhan University

基　　金：武汉大学医学部教学改革研究项目(编号:2019018)。

摘　　要：目的:总结现阶段新型冠状病毒(SARS-CoV-2)感染相关脑炎的临床特点、辅助检查、诊断、治疗及预后。方法:分析2022年12月至2023年2月在武汉大学人民医院神经内科就诊的4例SARS-CoV-2感染相关脑炎患者的临床特点及诊治过程,随访并观察患者的转归预后。结果:4例患者中2例为女性,2例男性,1例患者发病期间需用辅助通气,2例患者有意识障碍,2例患者有精神症状。4例患者鼻咽拭子均可检测出SARS-CoV-2,而脑脊液中未检测到,且脑脊液常规生化正常和自身免疫性脑炎相关抗体为阴性。影像学表现各异。4例患者均预后良好。结论:SARS-CoV-2感染相关脑炎是SARS-CoV-2感染后可能出现的神经系统并发症之一,需要早期诊断和治疗。其机制可能不是病毒直接侵袭神经细胞,而与感染后引起的免疫和炎症反应相关。Objectives To summarize the clinical characteristics,auxiliary examinations,diagnosis,treatment,and prognosis of SARS⁃CoV‑2 infection⁃associated encephalitis.Methods The clinical characteristics,diagnosis,and treatment process of four patients with SARS‑CoV‑2 infection⁃associated encephalitis who were treated in the Department of Neurology in Renmin Hospital of Wuhan University from December 2022 to February 2023 were analyzed,and the prognosis of the patients was followed up.Results Among the four patients,two were female and two were male.During the onset of the disease,one patient received auxiliary ventilation,two patients had a disturbance of consciousness,and two patients had mental symptoms.SARS‑CoV‑2 was detected in the nasopharyngeal swabs of four patients,but not in cerebrospinal fluid.The routine and biochemical examinations of the cerebrospinal fluid were normal,and the autoimmune encephalitis⁃related antibodies were also negative.Their imaging manifestations were varied,and their outcomes were good.Conclusion COVID‑19⁃associated encephalitis is one of the possible neurological complications after SARS⁃CoV‑2 infection,which requires early diagnosis and treatment.The mechanism may not be a direct invasion of nerve cells by the virus,but rather related to the immune and inflammatory responses caused by infection.

关 键 词：新型冠状病毒 脑炎 磁共振表现 脑脊液 免疫治疗 

分 类 号：R742[医药卫生—神经病学与精神病学]