Outcome of acute necrotizing encephalopathy in relation to treatment with corticosteroids and gammaglobulin
Outcome of acute necrotizing encephalopathy in relation to treatment with corticosteroids and gammaglobulin
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DOI：
10.1016/j.braindev.2008.03.005
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发表时间：
2009-03-01
影响因子：
1.7
通讯作者：
Kurahashi, Hirokazu
中科院分区：
文献类型：
--
作者：
Okumura, Akihisa;Mizuguchi, Masashi;Kurahashi, Hirokazu
objective.研究急性坏死性脑病患儿的预后与类固醇和丙种球蛋白治疗之间的关系。方法.回顾性分析34例急性坏死性脑病患儿的临床经过和预后。分为脑干病变组和非脑干病变组各17例。早期类固醇使用定义为在发病后24小时内给予类固醇。当患者没有或轻度认知障碍时，结局被判定为良好，当患者有更严重的后遗症或死亡时，结局被判定为差。结果在无脑干病变的患者中，12例早期激素治疗的患者中有7例预后良好，而5例未早期激素治疗的患者预后均较差。早期应用激素与未应用激素的患者在性别、年龄和实验室检查方面无显著性差异。结果与丙种球蛋白治疗无关。对于无脑干病变的患者，早期激素或丙种球蛋白治疗与预后无关。结论.无脑干病变的急性坏死性脑病患儿在发病后24 h内使用类固醇激素与预后较好有关。早期激素治疗是急性坏死性脑病治疗的重要选择。(C)2008 Elsevier B.V.保留所有权利。
Objective. To examine the relation between outcome and treatment with steroids and gammaglobulin in children with acute necrotizing encephalopathy. Methods. We retrospectively evaluated the clinical course and Outcome of 34 children with acute necrotizing encephalopathy. They were divided into two groups; 17 patients with brainstem lesion and 17 patients without brainstem lesion. Early steroid use was defined as when steroids were administered within 24 h after the onset. The outcome was judged as good when a patient had no or mild cognitive impairment and poor when a patient had more severe sequelae, or died. Results. Among patients without brainstem lesions, the outcome was good in 7 of 12 with early steroid, whereas it was poor in all 5 patients without early steroid. There was no significant difference in sex, age, and laboratory data between patients with and without early steroid. The outcome was not correlated with gammaglobulin treatment. As to patients without brainstem lesions, the outcome was not correlated with early steroid or gammaglobulin treatment. Conclusions. Steroid within 24 h after the onset was related to better outcome of children with acute necrotizing encephalopathy without brainstem lesions. Early steroid treatment will be an important option of the treatment for acute necrotizing encephalopathy. (C) 2008 Elsevier B.V. All rights reserved.