婴儿急性中枢神经系统病毒感染的常见致病菌群和不良预后相关因素的临床分析

摘要

目的探讨婴儿急性中枢神经系统病毒感染的常见致病菌群，分析不良预后的相关因素，为婴儿急性中枢神经系统病毒感染的临床治疗提供理论指导。方法选取2014年3月至2015年3月期间就诊的160例患有急性中枢神经系统病毒感染疾病的婴儿为研究对象，结合患者临床资料并采用荧光定量聚合酶链反应（ FQ-PCR）方法对婴儿急性中枢神经系统病毒感染的常见致病菌群进行分析和整理，确定主要病毒致病菌类型。根据患者出院时的格拉斯哥预后评分标准，将其分为不良预后组和良好预后组。对两组患儿临床表现、恢复程度、检查结果进行比较分析，探讨影响小儿急性中枢神经系统病毒感染不良预后的相关因素。结果婴儿急性中枢神经系统病毒感染的常见致病菌群主要有肠道病毒（EV）、乙型脑炎病毒（JEV）、腮腺炎病毒（MuV）、双埃可病毒（HPeV）等。160例患儿中，良好预后患儿128例，不良预后患儿32例。预后不良组患儿入院前病程、持续发烧时间过长，血钙值、脑脊液白细胞数量、脑脊液乳酸含量均高于预后良好组，差异具有统计学意义（ P ﹤0.05）；两组患儿年龄、生活环境、C反应蛋白、脑脊液蛋白含量等因素比较，差异无统计学意义（ P ﹥0.05）。Logistic多元回归分析结果显示，病程、持续发烧时间、血钙值、脑脊液白细胞数量、脑脊液乳酸含量是导致患儿近期不良预后的独立危险因素。结论婴儿急性中枢神经系统病毒感染的常见致病菌群具有多样性，主要包括EV、JEV、MuV、HPeV等类型；根据影响患儿近期不良预后的独立危险因素，可以有效指导急性中枢神经系统病毒感染婴儿的预防和治疗。%Objective To explore the common pathogenic bacteria group and poor prognosis related factors in infant acute viral infection of the central nervous system desease. Methods 160 cases of infants with acute central nervous system infection disease were selected during March 2014 to March 2014 as the research objects. FQ-PCR method was performed to study the common pathogenic bacteria in infant acute viral infec-tion of the central nervous system,to estimate the major types of viral pathogens. According to patients Glasgow prognostic score,all acute central nervous system infection infants were divided into poor prognosis and good prognosis group. The poor prognosis related factors in infant acute viral infection of the central nervous system desease were discussed. Results FQ-PCR test results showed that:common pathogenic bacteria in acute central nervous system infection infants mainly included enterovirus( EV),Japanese encephalitis virus( JEV),mumps virus( MuV),double el virus( HPeV),etc. In the 160 cases acute central nervous system infection infants,there were 128 cases infants with good prognosis and 32 cases infants with poor prognosis. Relevant data showed that prognosis of two groups of infants with the different indicators( P ﹤0. 05),such as the hospital course,fever,blood calcium values and cerebrospinal fluid,etc. Logistic multivariate regression model analysis showed that these inde-pendent risk factor were closely affect the prognosis of patients with acute central nervous system. Conclusion Common pathogenic bacteria group in acute viral infection of the central nervous system desease mainly include EV,JEV,MuV and HPeV;according to patientsˊrecent independent risk factor in poor prognosis infants,we can effectively avoid infection in acute central nervous system desease.