肠道感染相关性脑病

Clinical outcome of gut infection-associated encephalopathy syndrome

目的探讨肠道感染相关性脑病的临床特点。方法分析15例与文献报道的肠道感染相关性脑病相一致的患儿特点。结果均为突发高热、惊厥、水样腹泻、代谢性酸中毒、肝酶显著升高,前躯期为严重水样便、发热。大便检测6例轮状病毒阳性,脑功能障碍和肝功能损害为主要表现是本病的临床特点;肝酶学极显著改变,血胆红素多正常。入院1-2 d后肝转氨酶达高峰,多于1周内恢复正常,病情缓解。本组无一例死亡,2例遗留神经系统后遗症。结论应提高对肠道感染相关性脑病的临床认识。治疗关键是纠正脱水、酸中毒,肠源性的全身炎症反应可能参与发病机制。

Objective To explore clinical features of gut infection - associated encephalopathy syndrome. Methods The clinical data were analyzed in 15 children whose clinical course and laboratory parameters were compatible with the diagnosis of gut infection - associated encephalopathy syndrome,the abrupt onset of symptoms including seizures, hyperthermia, diarrhea, acidosis ,and hepatle dysfunction was observed in all cases following several days of prodromal illness with diarrha and fever. Results Rotavirus in the stool was identified in 6 patients. The infcction was characterized with neurologic mirbidity and hepatic dysfunction. The activities of aspartate aminotransferase and alanine aminotransferase increased markedly ,but the plasma levels of bilirubin were generally normal, the abnormalities peak in the activities of hepatic aminotransferase was within 24 -48 hours after admission reverted to normal level within one week for most of them. Of the 15 cases, no died,two cases survived but with neurologic sequelae, others were normal neurologically, Conclusion It is important to enhance the awareness of gut infection - associated encephalopathy syndrome clinically. To correct hydropenla and acidosis is the key to cure gut infection - associated encephalopathy syndrome suceessthlly, Systemic inflammatnry response syndrome （IRS） from gastrointestinal tract may contribute to probably.