| 基于mNGS的带状疱疹病毒脑炎/脑膜炎预后分析 |
| 投稿时间：2024-09-28 修订日期：2024-11-17 点此下载全文 |
| 引用本文：韩敬哲,纪叶,韩翠芝,司志华,刘汝茜.基于mNGS的带状疱疹病毒脑炎/脑膜炎预后分析[J].医学研究杂志,2025,54(4):141-145 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.025 |
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| 基金项目:河北省医学科学研究课题(20240959)；河北省衡水市科技计划自筹经费项目(2023014032Z) |
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| 中文摘要:目的 水痘-带状疱疹病毒(varicella-zoster virus, VZV)是病毒性脑炎/脑膜炎的常见病原体,目前宏基因组学第2代测序(metagenomic next generation sequencing, mNGS)可以快速精准实现对VZV脑炎/脑膜炎的定性诊断,但缺乏依据脑脊液mNGS序列数预测VZV脑炎/脑膜炎预后的研究。本研究从mNGS序列数角度探讨VZV脑炎/脑膜炎不良预后的危险因素,以提高临床预测性。方法 选取2016年1月～2022年10月在衡水市人民医院神经内科住院并经脑脊液(cerebrospinal fluid,CSF)mNGS确诊的VZV脑炎患者54例。依据出院3个月格拉斯哥结局量表(Glasgow outcome scale, GOS)评分分为预后良好组(n=26)和预后不良组(n=28),分析并总结两组患者的临床特点、辅助检查及预后。结果 两组患者中糖尿病患者比例、体温≥38℃患者比例、出现神经系统症状到应用抗病毒药物时间间隔、脑脊液白细胞计数和mNGS检出序列数差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,既往糖尿病史、脑脊液白细胞计数水平和脑脊液mNGS检出VZV序列数是VZV脑炎/脑膜炎患者预后不良的独立危险因素(P<0.05)。结论 合并糖尿病、CSF中白细胞计数水平越高、mNGS检出序列数越高的VZV脑炎/脑膜炎患者出院3个月后的预后越差。 |
| 中文关键词:水痘带状疱疹病毒 脑膜炎 脑炎 脑脊液 宏基因组学第2代测序 |
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| Prognostic Value of Cerebrospinal Fluid Sequencing Reads in Varicella-Zoster Virus Encephalitis/Meningitis:An Analysis Based on metagenomic Next Generation Sequencing. |
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| Abstract:Objective Varicella zoster virus (VZV) is a prevalent etiological agent of viral encephalitis/meningitis, and metagenomic next generation sequencing (mNGS) has demonstrated its capability to rapidly and accurately diagnose VZV encephalitis/meningitis. However, there are limited studies investigating the prognostic value of mNGS sequence reads in cerebrospinal fluid (CSF) for VZV encephalitis/meningitis. In this study, we aimed to identify risk factors associated with poor prognosis in VZV encephalitis/meningitis patients based on mNGS sequence reads, aiming to enhance clinical prediction. Methods A total of 54 patients diagnosed with VZV encephalitis, confirmed by cerebrospinal fluid mNGS, were selected from the Department of Neurology at Hengshui People′s Hospital between January 2016 and October 2022. Based on the Glasgow outcome scale(GOS)three months post-discharge, patients were categorized into a good prognosis group (26 cases) and a poor prognosis group (28 cases). The clinical features, auxiliary examinations, and prognostic outcomes of both groups were analyzed and summarized. Results Statistically significant differences were observed between the two groups in terms of diabetes prevalence, incidence of high fever, time interval between onset of neurological symptoms and initiation of antiviral treatment, leukocyte count in CSF, as well as the mNGS sequence reads (P<0.05). Multivariate Logistic regression analysis revealed that a history of diabetes mellitus, elevated leukocyte levels in CSF, and higher number of VZV sequence reads detected by mNGS in CSF independently contributed to poor prognosis among patients with VZV encephalitis/meningitis (P<0.05). Conclusion Patients with VZV encephalitis/meningitis who have comorbid diabetes mellitus along with higher leukocyte levels in CSF and increased mNGS sequence reads exhibited worse prognoses three months after discharge. |
| keywords:Varicella zoster virus Meningitis Encephalitis Cerebrospinal fluid Metagenomic next generation sequencing |
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