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糖皮质激素真的能改善单纯疱疹病毒 1 型脑炎的临床预后吗?
Authors Xie S, Sun W, Lai Z, Liu X
Received 3 December 2024
Accepted for publication 20 February 2025
Published 5 March 2025 Volume 2025:18 Pages 1287—1296
DOI https://doi.org/10.2147/IDR.S501628
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Sandip Patil
Shuhua Xie, Wei Sun, Zhaohui Lai, Xianghong Liu
Department of Neurology, Ganzhou People’s Hospital, Jiangxi, 341000, People’s Republic of China
Correspondence: Xianghong Liu, Email lxh7176@126.com
Background: Survivors of herpes simplex encephalitis (HSE) commonly experience significant neurological sequelae, imposing a substantial burden on both society and families. The efficacy of glucocorticoids in treating patients with HSE remains controversial. This study aims to evaluate the effectiveness of glucocorticoids in patients with HSE and analyze the clinical characteristics of this patient population.
Methods: This retrospective study evaluated the clinical characteristics, auxiliary examinations, and patient prognosis of HSE patients diagnosed with mNGS, and analyzed the prognosis of patients in both Glucocorticoid and Non-glucocorticoid groups. Assess the prognosis based on the improvement of GOS score and MMSE score at 1 and 3 months after discharge.
Results: A retrospective analysis was conducted in 29 hSE patients who met the criteria for GOS score improvement 3 months after discharge. The hormone group was better than the non-hormone group (2 (0– 2) scores VS 1 (1– 2) scores). There was no significant difference between the two groups in GOS score 1 month after discharge. However, no statistical difference was found in improving patient outcomes between the two groups.
Conclusion: Despite the hormone group not obtaining the anticipated positive outcomes, potentially due to the relatively limited sample size in this study, previous case series reports have indicated that glucocorticoids, when used as an adjunct to acyclovir therapy, may enhance patient outcomes. Consequently, further extensive clinical studies involving multiple centers and larger sample sizes are warranted to investigate this matter further.
Keywords: herpes simplex encephalitis, herpes simplex virus, glucocorticoid, atypical clinical manifestations, clinical prognosis