成人单纯疱疹病毒性脑炎的诊断及治疗进展

Progress of Diagnosis and Therapy for Adults′Herpes Simplex Encephalitis

单纯疱疹病毒性脑炎(HSE)有较高的病死率和致残率,早期诊断和抗病毒治疗的启动与患者能否获得良好的预后密切相关。随着对HSE研究的不断深入,以及现有医疗检查手段的不断进步,临床对成人单纯疱疹病毒(HSV)的诊断效率与准确性有了飞跃发展,并为早期启动抗病毒治疗提供了可能。目前,阿昔洛韦仍是治疗成人HSV的唯一有效抗病毒药物。抗病毒药物在特殊人群中的用法以及联合用药的疗效是当前临床研究的热点。同时,免疫调节剂的应用以及外科治疗的起步也均对改善患者预后起到了举足轻重的作用。

Herpes simplex encephalitis(HSE)has a high mortality and disability rate.The earlier diagnosis and antiviral treatment,the better outcomes the patients may receive.With the continuous deepening of study in HSE and progress of medical examination methods,the efficiency and accuracy of diagnosis of HSE have seen a leap forward,which has provided the possibility of early administration of antiviral therapy.Nowadays,acyclovir is still the only effective antiviral agent for HSV in adults.The usage of antiviral drugs in special population and the efficacy of combination drugs are the hotspots of the clinical research at present.Moreover,the application of immunomodulator and surgical treatment have also played important roles in improving prognosis of the patients.