病毒性脑炎的临床特点及预后影响因素研究

摘要

Objective To explore the clinical and imaging features of viral encephalitis and to understand its short time prognosis. Methods Clinical data of 160 viral encephalitis inpatients diagnosed during January 2006 - May 2010, in the First Affiliated Hospital of Chongqing Medical University, were analyzed retrospectively. All patients were divided into good and poor prognosis groups according to the Glasgow Outcome Scale, and several factors were analyzed by Logistic regressive analysis. Results The univariate analysis showed that anomaly of cranial MRI, moderate or serious anomaly of EEG, abnormal consciousness, abnormal mental behaviors, abnormal muscular power, epilepsy, and headache may correlated with the prognosis. However, the multifactor analysis showed that only anomaly of cranial MRI and abnormal consciousness had a definite relation with the prognosis []P = 0.03, OR = 13.0, 95% CI (2.40, 70.46)]. Conclusion The prognosis of viral encephalitis is related to several factors. But anomaly of cranial MRI and abnormal consciousness are the most important factors to its short time prognosis of viral encephalitis, and the more the cranial lesions are, the worse the prognosis is.%目的 了解病毒性脑炎(VE)的临床特征和影像学特征,探讨VE近期预后的相关影响因素.方法 回顾性分析2006年1月-2010年5月重庆医科大学附属第一医院住院治疗的临床诊断为VE的160例患者的临床资料,应用格拉斯哥评分(GOS)将其分为预后良好组和预后不良组,对多个因素与预后的关系进行Logistic回归分析.结果 单因素分析显示颅脑MRI异常、脑电图中重度异常、意识状态异常、精神行为异常、肌力异常、癫痫、头痛与VE预后可能有关系.多因素分析显示仅颅脑MRI异常和意识状态异常与VE预后有明确关系,MRI多个病灶较单个病灶预后更差[P=0.03,OR =13.0,95％CI (2.40,70.46)].结论 VE的预后是多因素共同作用的结果,意识状态异常、颅脑MRI异常是影响VE近期预后的两个重要危险因素.MRI显示颅内病灶越多者预后越差.