儿童急性坏死性脑病的临床特征及预后相关因素分析  

Analysis of clinical features and prognostic factors of acute necrotic encephalopathy in children

作　　者：危艺臻 刘洪[1] 陈凯 陈媛媛[1] Wei Yizhen;Liu Hong;Chen Kai;Chen Yuanyuan(Jiangxi Children’s Hospital,Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省儿童医院,江西南昌330006

出　　处：《首都食品与医药》2025年第9期28-31,共4页Capital Food Medicine

摘　　要：目的 观察儿童急性坏死性脑病(ANE)临床特征并分析其预后影响因素。方法 回顾性收集2019年1月-2024年1月入住江西省儿童医院的40例ANE患儿,根据出院临床结局分为预后良好组、存在严重神经系统后遗症组与死亡组三组,比较三组临床特征,采用多因素Logistic回归分析观察ANE患儿预后相关因素。结果 ANE患儿以发热、抽搐、昏迷、头痛、呕吐、休克为主要表现;合并基础疾病有9例;脑脊液显示白细胞正常;单变量分析提示降钙素原、GCS评分、格拉斯哥预后评分(GOS)、ANE严重程度评分(ANE-SS)、凝血酶原时间(PT)、尿素氮(BUN)、血肌酐、血乳酸可能是预后不良的相关影响因素(P<0.05);Logistic回归分析GCS评分、GOS评分、ANE-SS评分、PT、BUN为ANE预后相关因素(P<0.05)。结论 ANE以发热、抽搐、昏迷、头痛、呕吐等为首发症状,可根据GCS评分、GOS评分、ANE-SS评分、PT、BUN等因素的识别予以积极治疗。Objective To observe the clinical features of acute necrotizing encephalopathy(ANE)in children and analyze the prognostic factors.Methods 40 cases of ANE children admitted to Jiangxi Children’s Hospital from January 2019 to January 2024 were retrospectively collected and divided into three groups according to discharge clinical outcomes:good prognosis group,severe neurological sequelae group and death group.The clinical characteristics of the three groups were compared,and the prognostic factors related to ANE children were observed by multivariate Logistic regression analysis.Results The main manifestations of ANE were fever,convulsion,coma,headache,vomiting and shock.There were 9 cases with underlying diseases.Cerebrospinal fluid showed normal white blood cells.Univariable analysis suggested that procalcitonin,GCS score,Glasgow prognosis score(GOS),ANE severity score(ANE-SS),prothrombin time(PT),urea nitrogen(BUN),serum creatinine and blood lactic acid might be related factors of poor prognosis(P<0.05).Logistic regression analysis showed that GCS score,GOS score,ANE-SS score,PT and BUN were the prognostic factors of ANE(P<0.05).Conclusion The initial symptoms of ANE are fever,convulsion,coma,headache and vomiting,and can be actively treated according to the identification of GCS score,GOS score,ANE-SS score,PT and BUN.

关 键 词：儿童急性坏死性脑病 临床特征 预后 影响因素 

分 类 号：R742[医药卫生—神经病学与精神病学]