影响成人病毒性脑炎预后的危险因素分析

Analysis of Risk Factors Affecting Prognosis of Adult Viral Encephalitis

目的探讨影响成人病毒性脑炎预后的危险因素,为对其进行早期识别和干预、改善患者预后提供临床参考.方法回顾性分析56例成人病毒性脑炎患者的临床资料,通过单因素分析及多因素Logistic回归分析比较预后良好及预后不良患者的一般情况、临床特征、实验室检查指标及影像学诊断结果,寻找影响患者预后的危险因素.结果单因素分析结果显示,预后不良组早期意识障碍、精神行为异常、癫痫及病理征阳性发生率均高于预后良好组患者(P<0.05),预后不良组外周血白细胞水平高于预后良好组(P<0.05),而预后不良组患者的血钾、血钠水平均低于预后良好组(P<0.05);经多因素Logistic回归分析,精神行为异常(P<0.05,OR=8.001,95%CI 1.357~47.188)和病理征阳性(P<0.05,OR=9.076,95%CI 1.347~61.167)是影响成人病毒性脑炎患者预后的独立危险因素.结论成人病毒性脑炎患者存在精神行为异常及病理征阳性提示预后不良,应及时给予合理治疗,以改善患者预后.

Objective To analyze the risk factors affecting the prognosis of adult viral encephalitis,it provides the theoretical basis for early identification and intervention to improve the prognosis of patients.Method Clinical data of 56 adult patients with viral encephalitis were retrospectively analyzed.Univariate analysis and multivariate Logistic regression analysis were used to compare the general clinical characteristics,clinical features,laboratory indicators and imaging examinations of patients with good prognosis and poor prognosis,so as to find the risk factors affecting the prognosis of patients.Results Univariate analysis showed that the incidence of early consciousness disorder,abnormal mental behavior,epilepsy and pathology in the poor prognosis group was higher than those in the good prognosis group(P<0.05),the levels of peripheral white blood cells in poor prognosis group were higher than those in good prognosis group,while the levels of blood potassium and sodium in poor prognosis group were lower than those in good prognosis group(P<0.05);After multivariate Logistic regression analysis,mental and behavioral abnormalities(P<0.05,OR=8.001,95%CI 1.357~47.188)and positive pathological symptoms(P<0.05,OR=9.076,95%CI 1.347~61.167)was an independent risk factor for the prognosis of adult viral encephalitis.Conclusion Adult viral encephalitis patients with abnormal mental behavior,positive pathological symptoms indicate poor prognosis,and should be given reasonable treatment in time to improve the prognosis.