中国感染控制杂志2025，Vol.24Issue(3)：388-395,8.DOI:10.12138/j.issn.1671-9638.20256672
SARS-CoV-2感染相关脑炎的临床特点
Clinical characteristics of SARS-CoV-2 infection-related encephalitis
摘要
Abstract
Objective To summarize the clinical characteristics and pathogenesis of severe acute respiratory syn-drome coronavirus 2(SARS-CoV-2)infection-related encephalitis,aiming to provide new theoretical basis for clini-cal diagnosis and treatment.Methods Clinical characteristics as well as diagnosis and treatment process of 25 pa-tients with SARS-CoV-2 infection-related encephalitis in the Second Affiliated Hospital of Shandong First Medical University were analyzed,and the pathogenesis was evaluated.Results The main prodromal symptoms were fever(80.0％),the initial symptoms were consciousness disturbance(56.0％),epileptic seizures(52.0％),and mental symptoms(36.0％).The subsequent symptoms were mainly autonomic nerve dysfunction(88.0％),epileptic sei-zures(68.0％),cognitive dysfunction(68.0％),motor impairment(64.0％),and language dysfunction(52.0％).The auxiliary examination results were mainly increase of content of cerebrospinal fluid(CSF)protein and increase ofC-reactive protein(CRP);electroencephalogram(EEG)showed slowing down of a non-specific background rhythm,followed by abnormal discharges;the most common manifestation of magnetic resonance imaging(MRI)was abnormal high signal in the insular cortex and medial temporal lobe,followed by diffuse or focal microbleeds.The first-line treatment agents were glucocorticoid combined with immunotherapy,and the second-line treatment agent was monoclonal antibody.The prognosis was poor.Conclusion Patients with a history of exposure to SARS-CoV-2 infection,consciousness disturbance,epileptic seizures and mental symptoms should be vigilant to the possi-bility of encephalitis.CSF,EEG,and MRI auxiliary examination should be given.Once diagnosed,early interven-tion is necessary.The main pathogenesis include direct invasion,cytokine storm,excessive immune inflammation,specific lymphocyte response,etc.关键词
SARS-CoV-2/脑炎/脑电图/磁共振/托珠单抗Key words
SARS-CoV-2/encephalitis/electroencephalogram/magnetic resonance imaging/tocilizumab分类
临床医学引用本文复制引用
高敏,袁慧..SARS-CoV-2感染相关脑炎的临床特点[J].中国感染控制杂志,2025,24(3):388-395,8.基金项目
泰安市科技发展项目(2021NS287) （2021NS287）
