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为了解广州地区儿童脑炎的临床症状、病因类型、流行病学特点，评估儿童的临床指标与脑炎严重程度的关系，本研究选取2020年7月至2021年5月于广州市妇女儿童医疗中心神经内科因脑炎住院且年龄<18岁的儿童作为研究对象，通过医院病案系统回顾性收集患儿的临床资料和病原体检测信息进行统计学分析。结果显示，脑炎患儿最常见的症状为发热，其次为抽搐。广州地区儿童脑炎最常见的类型是感染性脑炎，以单纯疱疹病毒感染最为常见，并且存在季节性流行趋势，发病人数在春季达到高峰。此外，肺炎支原体是引起感染性脑炎的第二大病原体。细菌感染多发生在1岁以下儿童，以大肠埃希菌和肺炎链球菌为主，但仍有一半以上的儿童不能明确病因。年龄<1岁的儿童住院时间最长，但1岁～4和≥5岁脑炎患儿的住院时间无统计学差异。发热或伴有支气管肺炎的患儿住院时间相对较长；细菌性脑炎患儿的住院时间最长，但自身免疫性脑炎和病毒性脑炎患儿的住院时间不存在统计学差异。因此，本研究初步了解了广州地区儿童脑炎的病因构成以及常见病原体的流行特点，未来还应加强感染性脑炎的流行病学和病原学监测，研发新的病原体检测技术，从而有效的降低儿童脑炎的发生。
Abstract：This study aimed to explore clinical symptoms,etiology,and clinical outcome of children with severe encephalitis. We identified patients through the Guangzhou Women and Children's Medical Center database and included children diagnosed with encephalitis and aged <18 years old admitted to the Department of Neurology between July 2020 and May 2021. We analyzed demographic characteristics,clinical symptoms and etiology.The most common symptom of childhood encephalitis is fever,followed by convulsions. The most common type of childhood encephalitis in Guangzhou is infectious encephalitis. Herpes simplex virus is the most common pathogen. There is a seasonal epidemic trend and the number of cases peaked in spring. In addition,Mycoplasma pneumoniae is the second major pathogen causing infectious encephalitis. Bacterial infections mostly occur in children under 1 year old,mainly caused by Escherichia coli and Streptococcus pneumoniae.Aged <1 year old children were hospitalized the longest period,but there was no statistically significant difference in children with encephalitis aged 1 to 4 years and ≥5 years of age. Children with fever or bronchial pneumonia were hospitalized relatively longer time. Children with bacterial encephalitis need the longest hospital stay,but there is no significant difference in hospital stay for children with immune-mediated encephalitis or viral encephalitis. Therefore,Infectious encephalitis epidemiological and virological surveillance should be further strengthened. Continued research and development of diagnostic techniques are needed to further improve rapid pathogen detection in childhood encephalitis.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.004130
中图分类号:R725.1;R181.3
引用信息:
[1]谢思钿,梁万莉,赵明奇,等.2020年7月至2021年5月广州地区儿童脑炎的流行病学和病因学研究[J].病毒学报,2022,38(03):635-643.DOI:10.13242/j.cnki.bingduxuebao.004130.
基金信息:
深圳市科技创新项目（项目号：KQTD20180411143323605）;题目：重要传染病精准预警与防治技术体系~~
2022-05-07
2022-05-07
2022-05-07