Chinese General Practice ›› 2023, Vol. 26 ›› Issue (17): 2125-2131.DOI: 10.12114/j.issn.1007-9572.2022.0832
• Original Research • Previous Articles Next Articles
Received:
2022-11-22
Revised:
2023-01-11
Published:
2023-06-15
Online:
2023-01-18
Contact:
SUN Suzhen
通讯作者:
孙素真
作者简介:
作者贡献:薛婧如负责资料的收集和整理,进行统计学分析并绘制图表,负责论文的构思和撰写;孙素真提出研究思路,负责论文的修订、质量控制及审校,对论文整体负责。
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0832
组别 | 例数 | 性别〔n(%)〕 | 年龄〔n(%)〕 | 发病季节〔n(%)〕 | 起病形式〔n(%)〕 | 发热〔n(%)〕 | 呼吸道症状〔n(%)〕 | 精神行为异常〔n(%)〕 | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
男 | 女 | ≤3岁 | 4~6岁 | ≥7岁 | 冬春季 | 夏秋季 | 急性 | 亚急性 | |||||
预后良好组 | 73 | 42(57.5) | 31(42.5) | 11(15.1) | 26(35.6) | 36(49.3) | 44(60.3) | 29(39.7) | 58(79.5) | 15(20.5) | 63(86.3) | 39(53.4) | 11(15.1) |
预后不良组 | 28 | 16(57.1) | 12(42.9) | 8(28.6) | 8(28.6) | 12(42.8) | 16(57.1) | 12(42.9) | 18(64.3) | 10(35.7) | 22(76.8) | 19(67.9) | 16(57.1) |
检验统计量值 | 0.001 | 2.437 | 0.082 | 2.499 | 0.420 | 1.724 | 18.291 | ||||||
P值 | 0.972 | 0.296 | 0.774 | 0.114 | 0.517 | 0.189 | <0.001 | ||||||
组别 | 意识障碍〔n(%)〕 | 局灶性神经功能障碍〔n(%)〕 | 癫痫发作〔n(%)〕 | 癫痫持续状态〔n(%)〕 | 肌力及肌张力异常〔n(%)〕 | 病理征阳性〔n(%)〕 | 脑膜刺激征阳性〔n(%)〕 | 血清MP-IgM抗体阳性〔n(%)〕 | MP抗体滴度〔n(%)〕 | 脑脊液WBC 〔M(P25,P75),×106/L〕 | |||
≥1∶160 | ≤1∶80 | ||||||||||||
预后良好组 | 17(23.3) | 16(21.9) | 18(24.7) | 5(6.8) | 8(11.0) | 6(8.2) | 0 | 55(75.3) | 54(74.0) | 19(26.0) | 31.00(4.00,105.00) | ||
预后不良组 | 18(64.3) | 23(82.1) | 14(50.0) | 10(35.7) | 13(46.4) | 12(42.9) | 2(7.1) | 23(82.1) | 21(75.0) | 7(25.0) | 11.00(3.00,29.25) | ||
检验统计量值 | 15.022 | 30.967 | 6.005 | 11.149 | 15.460 | 14.298 | — | 0.532 | 0.011 | -1.971b | |||
P值 | <0.001 | <0.001 | 0.014 | 0.001 | <0.001 | <0.001 | 0.075 | 0.466 | 0.916 | 0.049 | |||
组别 | 脑脊液单核细胞计数〔M(P25,P75),×106/L〕 | 脑脊液蛋白含量〔M(P25,P75),g/L〕 | 脑脊液糖含量( | 脑脊液乳酸含量〔M(P25,P75),mmol/L〕 | 脑脊液MP-PCR阳性〔n(%)〕 | 脑电图异常〔n(%)〕 | 颅脑MRI异常〔n(%)〕 | 抗病毒治疗〔n(%)〕 | 糖皮质激素治疗〔n(%)〕 | 丙种球蛋白治疗〔n(%)〕 | |||
预后良好组 | 24.00(2.50,76.00) | 0.24(0.18,0.34) | 3.43±0.61 | 1.53(1.36,1.80) | 19(26.0) | 43(58.9) | 24(32.9) | 63(86.3) | 16(21.9) | 23(31.5) | |||
预后不良组 | 6.50(2.25,22.50) | 0.24(0.16,0.53) | 3.67±0.75 | 1.64(1.36,2.08) | 8(28.6) | 26(92.9) | 21(75.0) | 22(78.6) | 22(78.6) | 21(75.0) | |||
检验统计量值 | -1.686b | -0.456b | 1.683a | -0.922b | 0.067 | 10.799 | 14.536 | 0.420 | 27.678 | 15.571 | |||
P值 | 0.092 | 0.649 | 0.095 | 0.357 | 0.796 | 0.001 | <0.001 | 0.517 | <0.001 | <0.001 |
Table 1 Comparison of clinical data between mycoplasma pneumoniae encephalitis children with favourble and unfavourble prognosis
组别 | 例数 | 性别〔n(%)〕 | 年龄〔n(%)〕 | 发病季节〔n(%)〕 | 起病形式〔n(%)〕 | 发热〔n(%)〕 | 呼吸道症状〔n(%)〕 | 精神行为异常〔n(%)〕 | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
男 | 女 | ≤3岁 | 4~6岁 | ≥7岁 | 冬春季 | 夏秋季 | 急性 | 亚急性 | |||||
预后良好组 | 73 | 42(57.5) | 31(42.5) | 11(15.1) | 26(35.6) | 36(49.3) | 44(60.3) | 29(39.7) | 58(79.5) | 15(20.5) | 63(86.3) | 39(53.4) | 11(15.1) |
预后不良组 | 28 | 16(57.1) | 12(42.9) | 8(28.6) | 8(28.6) | 12(42.8) | 16(57.1) | 12(42.9) | 18(64.3) | 10(35.7) | 22(76.8) | 19(67.9) | 16(57.1) |
检验统计量值 | 0.001 | 2.437 | 0.082 | 2.499 | 0.420 | 1.724 | 18.291 | ||||||
P值 | 0.972 | 0.296 | 0.774 | 0.114 | 0.517 | 0.189 | <0.001 | ||||||
组别 | 意识障碍〔n(%)〕 | 局灶性神经功能障碍〔n(%)〕 | 癫痫发作〔n(%)〕 | 癫痫持续状态〔n(%)〕 | 肌力及肌张力异常〔n(%)〕 | 病理征阳性〔n(%)〕 | 脑膜刺激征阳性〔n(%)〕 | 血清MP-IgM抗体阳性〔n(%)〕 | MP抗体滴度〔n(%)〕 | 脑脊液WBC 〔M(P25,P75),×106/L〕 | |||
≥1∶160 | ≤1∶80 | ||||||||||||
预后良好组 | 17(23.3) | 16(21.9) | 18(24.7) | 5(6.8) | 8(11.0) | 6(8.2) | 0 | 55(75.3) | 54(74.0) | 19(26.0) | 31.00(4.00,105.00) | ||
预后不良组 | 18(64.3) | 23(82.1) | 14(50.0) | 10(35.7) | 13(46.4) | 12(42.9) | 2(7.1) | 23(82.1) | 21(75.0) | 7(25.0) | 11.00(3.00,29.25) | ||
检验统计量值 | 15.022 | 30.967 | 6.005 | 11.149 | 15.460 | 14.298 | — | 0.532 | 0.011 | -1.971b | |||
P值 | <0.001 | <0.001 | 0.014 | 0.001 | <0.001 | <0.001 | 0.075 | 0.466 | 0.916 | 0.049 | |||
组别 | 脑脊液单核细胞计数〔M(P25,P75),×106/L〕 | 脑脊液蛋白含量〔M(P25,P75),g/L〕 | 脑脊液糖含量( | 脑脊液乳酸含量〔M(P25,P75),mmol/L〕 | 脑脊液MP-PCR阳性〔n(%)〕 | 脑电图异常〔n(%)〕 | 颅脑MRI异常〔n(%)〕 | 抗病毒治疗〔n(%)〕 | 糖皮质激素治疗〔n(%)〕 | 丙种球蛋白治疗〔n(%)〕 | |||
预后良好组 | 24.00(2.50,76.00) | 0.24(0.18,0.34) | 3.43±0.61 | 1.53(1.36,1.80) | 19(26.0) | 43(58.9) | 24(32.9) | 63(86.3) | 16(21.9) | 23(31.5) | |||
预后不良组 | 6.50(2.25,22.50) | 0.24(0.16,0.53) | 3.67±0.75 | 1.64(1.36,2.08) | 8(28.6) | 26(92.9) | 21(75.0) | 22(78.6) | 22(78.6) | 21(75.0) | |||
检验统计量值 | -1.686b | -0.456b | 1.683a | -0.922b | 0.067 | 10.799 | 14.536 | 0.420 | 27.678 | 15.571 | |||
P值 | 0.092 | 0.649 | 0.095 | 0.357 | 0.796 | 0.001 | <0.001 | 0.517 | <0.001 | <0.001 |
组别 | 例数 | 总T淋巴细胞 | CD4+T淋巴细胞 | CD8+T淋巴细胞 | CD4/CD8 |
---|---|---|---|---|---|
预后良好组 | 51 | 66.77±11.28 | 33.80±8.82 | 26.34±11.89 | 1.49±0.61 |
预后不良组 | 22 | 63.18±11.86 | 32.53±8.58 | 23.87±8.56 | 1.50±0.55 |
t值 | -1.229 | -0.567 | -0.878 | 0.051 | |
P值 | 0.223 | 0.572 | 0.383 | 0.959 |
Table 2 Comparison of T-lymphocyte subsets during the acute phase of mycoplasma pneumoniae encephalitis in children with favourble and unfavourble prognosis
组别 | 例数 | 总T淋巴细胞 | CD4+T淋巴细胞 | CD8+T淋巴细胞 | CD4/CD8 |
---|---|---|---|---|---|
预后良好组 | 51 | 66.77±11.28 | 33.80±8.82 | 26.34±11.89 | 1.49±0.61 |
预后不良组 | 22 | 63.18±11.86 | 32.53±8.58 | 23.87±8.56 | 1.50±0.55 |
t值 | -1.229 | -0.567 | -0.878 | 0.051 | |
P值 | 0.223 | 0.572 | 0.383 | 0.959 |
组别 | 例数 | IgA | IgM | IgG |
---|---|---|---|---|
预后良好组 | 67 | 1.30±0.56 | 1.34±0.42 | 11.37±4.57 |
预后不良组 | 27 | 1.35±0.84 | 1.26±0.49 | 11.26±5.30 |
t值 | 0.287 | 0.851 | -0.104 | |
P值 | 0.775 | 0.397 | 0.918 |
Table 3 Comparison of immunoglobulin levels in children with mycoplasma pneumoniae encephalitis
组别 | 例数 | IgA | IgM | IgG |
---|---|---|---|---|
预后良好组 | 67 | 1.30±0.56 | 1.34±0.42 | 11.37±4.57 |
预后不良组 | 27 | 1.35±0.84 | 1.26±0.49 | 11.26±5.30 |
t值 | 0.287 | 0.851 | -0.104 | |
P值 | 0.775 | 0.397 | 0.918 |
变量 | B | SE | Wald χ2值 | P值 | OR值 | (95%CI) |
---|---|---|---|---|---|---|
精神行为异常 | 0.638 | 0.892 | 0.512 | 0.474 | 1.893 | (0.330,10.877) |
意识障碍 | 0.272 | 0.913 | 0.089 | 0.766 | 1.313 | (0.219,7.863) |
局灶性神经系统功能障碍 | 1.839 | 0.851 | 4.675 | 0.031 | 6.292 | (1.188,33.327) |
癫痫发作 | -1.846 | 1.154 | 2.558 | 0.110 | 0.158 | (0.016,1.516) |
癫痫持续状态 | 2.892 | 1.369 | 4.460 | 0.035 | 18.031 | (1.231,264.082) |
肌力及肌张力异常 | -0.400 | 1.147 | 0.122 | 0.727 | 0.670 | (0.071,6.344) |
病理征阳性 | 1.497 | 1.118 | 1.795 | 0.180 | 4.470 | (0.500,39.965) |
脑脊液WBC | <0.001 | 0.004 | <0.001 | 0.994 | 1.000 | (0.992,1.008) |
脑电图异常 | 1.999 | 0.982 | 4.145 | 0.042 | 7.379 | (1.077,50.548) |
颅脑MRI异常 | 1.750 | 0.842 | 4.319 | 0.038 | 5.757 | (1.105,30.003) |
糖皮质激素治疗 | 2.521 | 1.246 | 4.092 | 0.043 | 12.441 | (1.082,143.114) |
丙种球蛋白治疗 | -0.756 | 1.207 | 0.392 | 0.531 | 0.470 | (0.044,5.000) |
常量 | -5.748 | 1.327 | 18.748 | <0.001 | 0.003 | — |
Table 4 Multivariate Logistic regression analysis of the risk factors for unfavourble prognosis in children with mycoplasma pneumoniae encephalitis
变量 | B | SE | Wald χ2值 | P值 | OR值 | (95%CI) |
---|---|---|---|---|---|---|
精神行为异常 | 0.638 | 0.892 | 0.512 | 0.474 | 1.893 | (0.330,10.877) |
意识障碍 | 0.272 | 0.913 | 0.089 | 0.766 | 1.313 | (0.219,7.863) |
局灶性神经系统功能障碍 | 1.839 | 0.851 | 4.675 | 0.031 | 6.292 | (1.188,33.327) |
癫痫发作 | -1.846 | 1.154 | 2.558 | 0.110 | 0.158 | (0.016,1.516) |
癫痫持续状态 | 2.892 | 1.369 | 4.460 | 0.035 | 18.031 | (1.231,264.082) |
肌力及肌张力异常 | -0.400 | 1.147 | 0.122 | 0.727 | 0.670 | (0.071,6.344) |
病理征阳性 | 1.497 | 1.118 | 1.795 | 0.180 | 4.470 | (0.500,39.965) |
脑脊液WBC | <0.001 | 0.004 | <0.001 | 0.994 | 1.000 | (0.992,1.008) |
脑电图异常 | 1.999 | 0.982 | 4.145 | 0.042 | 7.379 | (1.077,50.548) |
颅脑MRI异常 | 1.750 | 0.842 | 4.319 | 0.038 | 5.757 | (1.105,30.003) |
糖皮质激素治疗 | 2.521 | 1.246 | 4.092 | 0.043 | 12.441 | (1.082,143.114) |
丙种球蛋白治疗 | -0.756 | 1.207 | 0.392 | 0.531 | 0.470 | (0.044,5.000) |
常量 | -5.748 | 1.327 | 18.748 | <0.001 | 0.003 | — |
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