| Objective:To analyze the clinical data and related auxiliary examination data of243 patients with Tick-borne encephalitis(TBE)in Yanbian area from 2012 to 2021,the clinical characteristics and prognosis of Tick-borne encephalitis in Yanbian area are clarified,which is the most important in this area.Provide new scientific basis for Tick-borne encephalitis prevention and treatment.Methods:The age,gender,occupation,region,onset time,degree of disease,outcome and clinical manifestations,laboratory examinations and auxiliary examinations,and cerebrospinal fluid examinations of 243 patients with TBE in Yanbian area from 2012 to 2021 were collected and analyzed by retrospective analysis method.Its clinical features and prognosis.Results:1.General situation:The main clinical manifestations of TBE patients in Yanbian area were fever 227cases(93.4%),headache 193 cases(79.4%),dizziness 96 cases(39.5%),nausea 100cases(41.1%),fatigue 47 cases(19.3%),muscle soreness 47 cases(19.3%).The main neurological abnormalities were unconsciousness in 39 cases(16.3%),coma in 25cases(10.2%),drowsiness in 11 cases(4.5%),speech disorder in 17 cases,dyspnea in12 cases,etc.Muscle weakness was found in 89 cases(36.6%),meningeal irritation was found in 86 cases(35.3%),pathological reflex was found in 8 cases(3.3%),and muscle tone was found in 17 cases(7%).There were no significant differences among different ethnic groups(P>0.05).2.Clinical manifestations and characteristics:Routine blood tests were performed in all 243 patients,of which 21 were leukocyte decreased and 111 were leukocyte increased(45.7%).The percentage of neutrophil decreased in 8 cases and increased in 154 cases(64.4%).There were 23 cases of occult blood,2 cases of positive urine protein,44 cases of positive microalbumin > 0.15g/L,18 cases of positive microalbumin combined with urine protein,11 cases of positive occult blood,1 case of positive cryptohematuria protein,17 cases of positive bacteria.The abnormality of liver function(AST,ALT)and myocardial enzyme(HBDH,LDH)were 66 and 97 cases,respectively.Of the 243 patients,117 had CSF examination,64 had normal pressure and 52 had elevated pressure.There were 94 cases of elevated protein,95 cases of abnormal chloride and33 cases of abnormal glucose.3.Laboratory examination and Auxiliary examination:All 243 patients underwent routine blood test,among which 21 cases of leukocytes were decreased and 111 cases were increased(45.7%);8 cases of neutrophil percentage were decreased and 154 cases(64.4%)were increased.Urine routine showed occult blood in 24 cases,urine protein positive in 17 cases,and microalbumin >0.15g/L in 14 cases.Abnormal liver function(AST,ALT)and abnormal myocardial enzymes(mainly HBDH,LDH)were found in 55 and 37 cases,respectively.Of the 243 patients,117 underwent cerebrospinal fluid examination,46 patients had normal cerebrospinal fluid pressure and 70 patients had elevated cerebrospinal fluid pressure;107 patients had elevated protein,105 patients had abnormal chloride,and 55 patients had abnormal glucose.A total of 136 cases were examined by MRI,of which 66 had no abnormal manifestations and 77 had abnormal manifestations,mainly patchy abnormal signal shadows.4.Analysis of prognosis and outcome factors:The different drug combinations had no significant effect in moderate(p=0.936)and severe(p=0.157)patients;but had a significant effect in mild patients(p=0.047).There were 48(19.8%)patients with residual sequelae,including 37 patients with muscle weakness.There were significant differences in age,length of stay,degree of meningeal stimulation,muscle strength,delirium,nerve performance and myocardial enzyme between the unhealed group and the cured group(P <0.05).The degree,muscle strength and cerebrospinal fluid protein of meningeal stimulation were the independent factors influencing the outcome of TBE patients.Logistic model can effectively predict the outcome of TBE patients.Conclusion:1.From 2012 to 2021,TBE in Yanbian area was most likely to occur fro m May to July,and the onset age was mainly 40-60 years old,males were m ore than females,and freelancers were the main occupation.There was no diff erence in incidence among ethnic groups.2.This study found that TBE in Yanbian area can lead to kidney damage,which can be improved after active treatment.3.There is a risk of breakthrough of TBE vaccine in Yanbian area,but allpatients with mild disease improved quickly after treatment without sequelae.4.Dexamethasone combined with ganciclovir and methylprednisolone combin ed with ganciclovir had better efficacy in mild patients.Age,length of stay,de gree of meningial stimulation,muscle strength,confusion,disturbance of consci ousness,myocardial enzymewere correlated with the outcome of TBE.Degree,muscle strength,meningeal irritation and cerebrospinal fluid protein were indep endent influencing factors.Logistic model can effectively predict the outcome ofTBE patients. |
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