发热伴血小板减少综合征相关脑炎治疗药物的研究进展

doi:10.6040/j.issn.1671-7554.0.2026.0311

摘要/Abstract

摘要： 发热伴血小板减少综合征相关脑炎(severe fever with thrombocytopenia syndrome-associated encephalitis, SFTSAE)是发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome, SFTS)最严重的神经系统并发症,病死率>40%,但目前临床尚无针对性的特异性治疗药物。现有方案多借鉴于SFTS一般治疗经验,未能充分考虑血-脑脊液屏障(blood-brain barrier, BBB)渗透性与神经靶向性问题。本文从抗病毒药物、被动免疫疗法、免疫调节药物及其他潜在治疗药物四个方面,系统综述各方案在SFTSAE中的应用现状与研究进展,重点关注药物的中枢神经系统渗透性与免疫干预时机,整合药物BBB穿透能力及干预时机对疗效影响的关键证据,并将JAK抑制剂、钙通道阻滞剂及阿莫地喹等“老药新用”方向的初步证据纳入SFTSAE治疗策略的评估框架,旨在为SFTSAE的精准用药提供循证依据,并提出未来应加强中枢药代动力学与联合治疗策略研究的展望。

Abstract: Severe fever with thrombocytopenia syndrome-associated encephalitis(SFTSAE)is the most severe neurological complication of severe fever with thrombocytopenia syndrome(SFTS), with a mortality rate exceeding 40%. However, no specific therapeutic agent is currently available for SFTSAE, and existing treatment protocols are largely extrapolated from general SFTS management, failing to adequately address blood-brain barrier(BBB)penetration and neuro-targeting properties of drugs. This review systematically summarizes the current status and research progress of antiviral drugs, passive immunotherapy, immunomodulatory agents, and other potential therapeutic candidates in the treatment of SFTSAE from four aspects, with a focus on evaluating central nervous system(CNS)penetration and timing of immunomodulatory intervention. It integrates key evidence on how BBB penetrability and intervention timing affect therapeutic efficacy, and incorporates preliminary evidence on "drug repurposing" strategies, including JAK inhibitors, calcium channel blockers, and amodiaquine, into the assessment framework for SFTSAE treatment. This review aims to provide evidence-based guidance for precision pharmacotherapy in SFTSAE and highlights the need for future research on CNS pharmacokinetics and combination therapeutic strategies.

Key words: Severe fever with thrombocytopenia syndrome-associated encephalitis, Blood-brain barrier penetration, Antiviral drugs, Immunomodulatory therapy

中图分类号:

R512.39

刘萍,张孝国,计胜伟,张忠法. 发热伴血小板减少综合征相关脑炎治疗药物的研究进展[J]. 山东大学学报 (医学版), 2026, 64(8): 23-28.

LIU Ping, ZHANG Xiaoguo, JI Shengwei, ZHANG Zhongfa. Research progress on therapeutic drugs for encephalitis associated with severe fever with thrombocytopenia syndrome[J]. Journal of Shandong University (Health Sciences), 2026, 64(8): 23-28.

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