Clinical Characteristics And Prognostic Risk Factors Of 104 Japanese Encephalitis Cases

Objective To analyze the clinical characteristics of Japanese encephalitis(JE)patients and explore the prognostic risk factors.Methods Retrospective analysis of the clinical data of JE cases admitted to the General Hospital of Ningxia Medical University from July to September 2018.Including general conditions,clinical symptoms,signs,cerebrospinal fluid(GSF),electromyography,brain MRI.Then they were followed up one year after onset.According to MRS standard and the survival outcome,they were divided into the good prognosis group and poor prognosis group.Multivariable Logistic regression analysis was conducted to analyze the risk factors for the prognosis of JE.Results1.The age ranged from 4 months to 80 years old,with a median age of 60 years,the highest number of patients was in the 50-70 age group,accounting for75 case(71.1%).Farmers are the main occupation.2.Fever was the most common first symptom of JE.The main clinical features included fever,headache,consciousness disorder,vomiting,and mental behavioral abnormalities,respectively accounting for 100.0%,71.1%,62.5%,55.8%,37.5%.The main signs were positive meningeal irritation sign,muscle weakness,decreased muscle tension,increased muscle tension and,respectively accounting for 61.5%,35.6%,23.1%,22.1%.3.Medical assistant examination:(1)CSF proteins were mostly elevated(86.5%);levels of glucose were normal(76.9%)or increased(21.2%);levels of chloride were normal(51.9%)or decreased(47.1%).(2)The abnormal rate of brain MRI was 53.7%.The main lesions were bilateral thalamus,hippocampus,and basal ganglia,respectively accounting for 35.4%,17.1%,13.4%.(3)Electromyographic results showed that patients had peripheral nerve damage.The abnormal rate of motor nerve conduction velocity was higher than sensory nerves(P <0.05);the abnormal amplitude of motor and sensory nerves was higher than the abnormal rate of conduction velocity(P <0.05);upper limb movement and sensory nerve conduction velocity abnormalities were higher than those in the lower limbs(P<0.05).4.Univariate analysis showed that both groups had significant differences in the hypertension history,age,time of diagnosis,duration of fever,respiratory failure,disturbance of consciousness,clinical classification,muscle weakness,decreased muscle tension,GSF glucose,and GSF protein(P<0.05).Multivariable Logistic regression analysis showed that age over 53 years old,CSF protein over 0.9g/L,heavy /serious type in clinical classification were independent risk factors for Poor prognosis of JE.Conclusion1.The onset of JE is acute,fever is the most common first symptom,the clinical symptoms are multifarious.2.Japanese encephalitis virus attacks the central nervous systems and peripheral nervous system at the same time.3.In this study,age over 53 years old,CSF protein over 0.9g/L, heavy/serious type in clinical classification were independent risk factors for Poor prognosis of JE.