Analysis of Risk Factors for Poor Prognosis in Patients with Viral Encephalitis
Objective To investigate the risk factors of poor prognosis in patients with viral encephalitis.Methods A total of 259 patients with viral encephalitis admitted to the hospital from June 2019 to May 2022 were studied.According to the prognosis,the patients were divided into poor prognosis group(79 cases)and good prognosis group(180 cases).The general clinical data of the two groups were compared[gender,age,hemiplegia,fever,hyponatremia,hypokalemia,length of hospital stay,onset to hospital stay,electroencephalogram,meninges irritation sign,serum creatinine(Scr),blood urea nitrogen(BUN),glutamic-pyruvic transaminase(GPT),glutamic-oxaloacetic transaminase(GOT),serum aproliferation-inducing ligand(APRIL),serum B lymphocyte stimulating factor(BlyS),serum reduced upon activation,normal T cell expressed and secreted(RANTES),serum recombinant ficolin 3(FCN3),serum cavalry protein 1(Caveolin-1),serum matrix metalloproteinase-2(MMP-2)].Multivariate logistic regression was used to analyze the risk factors of poor prognosis in patients with viral encephalitis,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of combined detection of serum APRIL,BlyS,RANTES,FCN3,Caveolin-1 and MMP-2 levels in patients with viral encephalitis.Results The levels of APRIL,BlyS,RANTES,FCN3,Caveolin-1 and MMP-2 in poor prognosis group were higher than those in good prognosis group(P＜0.05).Logistic regression analysis showed that serum APRIL(＞7.48 μg·L-1),BlyS(＞7.14 μg·L-1),RANTES(＞273.64 ng·L-1),FCN3(＞17.02 mg·L-1),Caveolin-1(＞15.62 μg·L-1),MMP-2(＞496.13 ng·L-1)levels were risk factors for poor prognosis in patients with viral encephalitis(P＜0.05).ROC curve results showed that the combined levels of serum APRIL,BlyS,RANTES,FCN3,Caveolin-1 and MMP-2 predicted the poor prognosis of patients with viral encephalitis with an area under the curve of 0.804,the best prediction sensitivity of 92.41％and specificity of 68.33％.Conclusion There is a correlation between the prognosis of patients with viral encephalitis and the levels of serum APRIL,BlyS,RANTES,FCN3,Caveolin-1 and MMP-2.The combined application of these serum can effectively predict the risk of poor prognosis and facilitate the formulation of prevention and treatment measures in early clinical stage.
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