【摘要】 目的 探讨儿童单纯水痘进展为水痘脑炎的影响因素。方法 采用回顾性病例对照设计，选取2005年11月至2024年5月北京佑安医院及北京地坛医院的水痘脑炎住院患儿67例（病例组）和同期同医院的单纯水痘住院患儿110例（对照组）。收集患儿的人口学特征、临床表现及实验室检查结果。采用多因素非条件logistic回归方程分析水痘脑炎的影响因素。结果 共纳入患儿177例，其中男125例、女52例；年龄1月～17.0岁，平均（6.3±5.2）岁。水痘脑炎患儿占比37.9%(67/177)。多因素回归分析结果显示，皮疹持续时间较长（OR=5.228,95%CI:2.477～11.035,P<0.001）、发热持续时间较长（OR=2.320,95%CI:1.410～3.815,P<0.001）、中性粒细胞百分比越高（OR=1.054,95%CI:1.013～1.096,P=0.010）及PLT越高（OR=1.007,95%CI:1.001～1.012,P=0.040）的单纯水痘患者，进展为水痘脑炎的风险越高。结论 发热时间延长、皮疹持续较久、中性粒细胞百分比增高及PLT升高是单纯水痘患儿发展为水痘脑炎的影响因素。建议对伴有发热或皮疹持续时间较长、中性粒细胞或PLT显著升高的单纯水痘患儿，予以密切临床观察，并考虑早期进行抗病毒治疗等干预措施，以降低进展为脑炎的风险。同时，加强水痘预防接种，从根本上减少水痘及相关严重并发症的发生。更多还原

【Abstract】 Objective To explore the influencing factors of progression from simple varicella to varicella encephalitis in children. Methods A retrospective case-control design study was conducted, and 67 hospitalized children with varicella encephalitis(case group) and 110 hospitalized children with simple varicella(control group) during the same period were selected from Beijing You’an Hospital and Beijing Di’tan Hospital from November 2005 to May 2024. Demographic characteristics, clinical manifestations and laboratory test results of the children were collected and analyzed. Multivariate unconditional logistic regression analysis was used to identify the influencing factors of varicella encephalitis. Results A total of 177 children(125 males and 52 females) were enrolled, aged from one month to seventeen years, with the mean age of(6.3 ± 5.2) years. Children with varicella encephalitis accounted for 37.9%(67/177) of cases. Multivariate regression analysis showed that the patients with simple varicella who had a longer duration of rash(OR = 5.228, 95%CI = 2.477-11.035, P < 0.001), longer duration of fever(OR = 2.320, 95%CI = 1.410-3.815, P < 0.001), higher percentage of neutrophils(OR = 1.054, 95%CI = 1.013-1.096, P = 0.010) and higher PLT count(OR = 1.007,95%CI = 1.001-1.012,P = 0.040) had a higher risk of progressing to varicella encephalitis. Conclusions Prolonged fever duration, longer duration of rash, increased neutrophil percentage and elevated PLT count are influencing factors for the progression from simple varicella to varicella encephalitis in children. It is suggested that children with simple varicella accompanied by prolonged fever or rash duration, or significantly elevated neutrophils or PLT count, receive closer clinical observation and early antiviral therapy or other interventions to reduce the risk of progression to encephalitis. Additionally, strengthening varicella vaccination is essential to fundamentally reduce the incidence of varicella and its related severe complications.更多还原