目的 总结儿童流感相关性脑病（influenza-associated encephalopathy, IAE）的临床及影像学特征，分析影响其预后的因素。 方法 回顾性分析2022年5月—2023年4月在南京医科大学附属儿童医院诊治的23例IAE的临床资料、实验室检查、影像学资料及预后情况。 结果 23例IAE患儿中，甲型流感18例（78%），乙型流感5例（22%）。23例患儿均有发热及脑病表现，20例（87%）出现抽搐发作，其中11例（48%）为惊厥持续状态。10例（43%）谷丙转氨酶升高，14例（61%）谷草转氨酶升高，18例（78%）乳酸脱氢酶升高。20例（87%）颅脑影像学结果异常，其中急性坏死性脑病（10例，43%）最为常见。23例均接受帕拉米韦或奥司他韦治疗。完全康复12例（52%），遗留不同程度的神经功能障碍5例（22%），死亡6例（26%）。预后不良组谷丙转氨酶、谷草转氨酶及乳酸脱氢酶水平高于预后良好组（P<0.05）。 结论 IAE临床表现以发热、抽搐最为常见，临床影像综合征以急性坏死性脑病最为常见；谷丙转氨酶、谷草转氨酶及乳酸脱氢酶水平升高对判断预后不良有一定价值。

Objective To study the clinical and imaging features of children with influenza-associated encephalopathy (IAE), and to investigate the influencing factors for prognosis. Methods A retrospective analysis was conducted on the medical data (clinical data, laboratory examinations, imaging data, and prognosis) of 23 children with IAE who were diagnosed and treated in Children's Hospital of Nanjing Medical University from May 2022 to April 2023. Results Among the 23 patients, 18 (78%) had influenza A and 5 (22%) had influenza B. All patients had fever and encephalopathy, and 20 patients (87%) had seizures, while 11 patients (48%) had persistent convulsions. There were 10 patients (43%) with an increase in alanine aminotransferase, 14 (61%) with an increase in aspartate aminotransferase, and 18 (78%) with an increase in lactate dehydrogenase. Abnormal imaging findings were observed in 20 patients (87%), among whom 10 (43%) had acute necrotizing encephalopathy. All 23 patients received peramivir or oseltamivir. Of all patients, 12 (52%) achieved complete recovery, 5 (22%) had varying degrees of neurological dysfunction, and 6 (26%) died. Compared with the good prognosis group, the poor prognosis group had significantly higher levels of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase (P<0.05). Conclusions Fever and convulsions are the most common symptoms of children with IAE, and acute necrotizing encephalopathy is the most common clinical imaging syndrome. Increases in alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase have a certain value in predicting poor prognosis.