成年和儿童日本脑炎患者的临床分析

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目的研究成年和儿童日本脑炎患者的临床差异。方法回顾性分析2004-07~2006-09我院治疗的日本脑炎患者,分为成年组和儿童组(<14岁,不包括新生儿),评定其临床资料和3个月时的预后。结果72.9%的患者来自经济卫生条件差的农村,14名成年(60.9%)和22名儿童(88%)患者出现癫发作(χ2=4.70,P<0.05)。2组患者在神经功能缺失、影像学及脑脊液分析方面无明显差异。成年患者急性期病死率高,而3个月时成年生存患者的预后好(χ2=7.96,P<0.05)。结论成年患者急性期病死率高,3个月时的预后较好;癫发作少见于成年患者,2组脑电图也有不同表现。上述差异可能与免疫因素、神经元可塑性及分化相关。 Objective To study the clinical differences of adult Japanese and Japanese children with Japanese encephalitis. Methods The Japanese encephalitis patients treated in our hospital from July 2004 to September 2006 were retrospectively analyzed. The patients were divided into adult group and children group (<14 years old, excluding newborn), and their clinical data and prognosis at 3 months were evaluated. Results 72.9% of the patients were from rural areas with poor economic health conditions. Epileptic seizures occurred in 14 adults (60.9%) and 22 children (88%) (χ2 = 4.70, P <0.05). There was no significant difference between the two groups in neurological deficits, imaging and cerebrospinal fluid analysis. Adult patients have a high rate of acute death in the acute phase, whereas those at 3 months have a better prognosis (χ2 = 7.96, P <0.05). Conclusion The mortality rate of adult patients in acute phase is high, and the prognosis is good at 3 months. Epileptic seizures are rare in adult patients. There are also different manifestations in 2 groups. The above differences may be related to immune factors, neuronal plasticity and differentiation.
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