■这项研究的目的是描述成人蜱传脑炎(TBE)后的长期神经和神经认知后遗症。
■98名前瞻性连续TBE患者,按疾病严重程度分类,包括在内。采用格拉斯哥结果量表(GOS)和Rankin量表(RS)评估近期结果。6个月和18个月后,使用改良的Rankin量表(MRS)评估长期残疾,并使用Matrics共识认知电池(MCCB)进行神经认知评估,测量处理速度,注意/警惕,工作记忆,口头学习,视觉学习,推理/解决问题和社会认知。将MCCB结果与健康年龄进行比较,性别和教育匹配的控制。
■温和,中度,53.1%的患者被诊断为严重的TBE,38.8%,8.2%的病例,分别。出院时,25.5%的患者有严重或中度损伤(GOS),34.7%的患者有不同程度的残疾(RS)。从TBE开始长达18个月,超过20%的人仍然患有轻度至中度残疾(MRS)。GOS,RS和MRS评分与疾病严重程度相关。发病后6个月,TBE患者在处理速度上得分明显低于对照组,口头,和视觉学习。轻度TBE患者的后两个结构域明显受损。18-39岁的患者在注意力/警惕性和工作记忆方面表现明显更差,而60岁以上的人在口头学习中。一年后,在7个认知领域中的6个领域观察到显著改善.
■长期的神经后遗症在TBE患者中持续存在,在几个认知领域有显著损害,尤其是年轻患者,甚至轻度TBE后。
UNASSIGNED: The aim of this study was to characterise long-term neurological and neurocognitive sequelae after tick-borne encephalitis (TBE) in adults.
UNASSIGNED: 98 prospective consecutive TBE patients, classified by disease severity, were included. Immediate outcomes were evaluated with Glasgow Outcome Scale (GOS) and Rankin Scale (RS). After 6 and 18 months, long-term disability was evaluated using Modified Rankin Scale (MRS) and neurocognitive assessment was performed with Matrics Consensus Cognitive Battery (MCCB), measuring processing speed, attention/vigilance, working memory, verbal learning, visual learning, reasoning/problem solving and social cognition. The MCCB results were compared to healthy age, gender and education-matched controls.
UNASSIGNED: Mild, moderate, and severe TBE was diagnosed in 53.1%, 38.8%, and 8.2% of cases, respectively. At discharge, 25.5% of the patients had major or moderate impairments (GOS) and various levels of disability in 34.7% (RS). Up to 18 months from the onset of TBE, over 20% remained with slight to moderate disability (MRS). GOS, RS and MRS scores correlated with disease severity. At 6 months after the onset, TBE patients scored significantly lower than controls in processing speed, verbal, and visual learning. Two latter domains were significantly more impaired in patients with mild TBE. Patients aged 18-39 performed significantly worse in attention/vigilance and working memory, whereas aged 60+ in verbal learning. A year later, significant improvement was observed in six of seven cognitive domains.
UNASSIGNED: Long-term neurological sequelae persist in a substantial proportion of TBE patients with significant impairment in several cognitive domains, especially in younger patients and even after mild TBE.