目的 探讨儿童流行性感冒（简称“流感”）相关性脑病（influenza‑associated encephalopathy, IAE）的临床特征、预后及相关影响因素。 方法 回顾性分析2015年1—2025年12月重庆医科大学附属儿童医院收治的186例流感伴神经系统症状住院患儿的资料。按是否符合急性脑病诊断标准分为IAE组与非IAE组，比较两组临床、实验室检查、影像学表现、治疗及预后差异。 结果 IAE组58例（31.2%），主要神经系统症状为惊厥及持续意识障碍（各40例，69.0%）。IAE组起病年龄大于非IAE组、脑电图及头颅影像学异常率高于非IAE组（P<0.05），且丘脑、基底节及脑干等深部结构受累比例升高（P<0.001）。IAE组院内死亡7例（12.1%），出院时遗留后遗症12例（20.7%）。中位随访12个月时，IAE组运动障碍、语言障碍、认知功能障碍发生率，以及远期预后不良率更高（P<0.05）。多因素logistic回归分析显示，年龄增长（OR=1.19）及血清乳酸脱氢酶升高（OR=1.01）与IAE发生呈正性关联（P<0.05）。 结论 IAE患儿以惊厥及持续意识障碍为神经系统主要表现，易累及深部脑结构，预后不良风险高；年龄增长及血清乳酸脱氢酶升高与IAE的发生密切相关。

Objective To investigate the clinical features, prognosis, and factors associated with influenza-associated encephalopathy (IAE) in children. Methods Clinical data of 186 children hospitalized with influenza and neurological symptoms at the Children's Hospital of Chongqing Medical University from January 2015 to December 2025 were retrospectively analyzed. Based on whether they met the diagnostic criteria for acute encephalopathy, patients were divided into the IAE group and the non-IAE group. Clinical manifestations, laboratory findings, neuroimaging characteristics, treatment, and outcomes were compared between the two groups. Results The IAE group included 58 patients (31.2%), with seizures and persistent disturbance of consciousness as the main neurological manifestations (40 cases each, 69.0%). Compared with the non-IAE group, the IAE group had an older age at onset and higher rates of electroencephalographic and neuroimaging abnormalities (P<0.05), with significantly more frequent involvement of deep brain structures including the thalamus, basal ganglia, and brainstem (P<0.001). In the IAE group, 7 patients (12.1%) died during hospitalization, and 12(20.7%) had neurological sequelae at discharge. At a median follow-up of 12 months, the incidences of motor, language, and cognitive dysfunctions, as well as the rate of poor long-term prognosis, were significantly higher in the IAE group (P<0.05). Multivariable logistic regression analysis showed that older age (OR=1.19) and elevated serum lactate dehydrogenase (OR=1.01) were positively associated with the occurrence of IAE (both P<0.05). Conclusions Pediatric IAE is characterized by seizures and persistent disturbance of consciousness, with a predilection for deep brain structures and a high risk of poor prognosis. Older age and elevated serum lactate dehydrogenase are closely associated with the development of IAE.