长沙地区住院儿童急性中枢神经系统病毒感染性疾病的病原学分析

发布时间：2018-11-27 21:36

【摘要】：目的持续观察长沙地区急性中枢神经系统病毒感染性疾病的病原学构成,为其防治提供参考依据。方法建立肠道病毒(EV)、麻疹病毒(MV)、腮腺炎病毒(MuV)、双埃可病毒(HPeV)、乙型脑炎病毒(JEV)、单纯疱疹病毒1型(HSV-1)、单纯疱疹病毒2型(HSV-2)、腺病毒(ADV)、水痘带状疱疹病毒(VZV)、EB病毒(EBV)、人类疱疹病毒6型(HHV-6)等11种病毒实时荧光定量PCR (FQ-PCR)检测方法。收集2011年10月至2013年7月湖南省人民医院儿童医学中心急性病毒性脑炎、脑膜炎及脑膜脑炎住院儿童CSF标本,并使用FQ-PCR方法检测EV、MV、MuV、HPeV、JEV、HSV-1、HSV-2、ADV、VZV、EBV、HHV-6等11种常见病毒。查阅相关病历资料,结合检测结果,对流行病学资料和临床特征进行分析。结果 1.成功构建EV、MV、MuV、HPeV、JEV、HSV-1、HSV-2、ADV、VZV、 EBV、HHV-6等11种病毒的标准品及标准曲线,建立了上述病毒FQ-PCR检测方法。 2.本研究期间收集了急性病毒性脑炎、脑膜炎及脑膜脑炎住院儿重CSF标本共161份,使用FQ-PCR方法检出71例病毒,总检出率44.10%(71/161)。EV检出率最高,为18.01%(29/161),其次为MuV,检出率8.07%(13/161),MV为7.45%(12/161), EBV、HPeV均为4.97%(8/161),ADV为3.73%(6/161),HHV-6为2.48%(4/161),JEV、HSV-1、HSV-2均为0.62%(1/161),未检出VZV。 3.161例住院儿童中,临床诊断为急性病毒性脑炎82例,急性病毒性脑膜炎20例,急性病毒性脑膜脑炎59例；男性93例,女性68例,男女比例为1.37：1；年龄最小为3个月,最大为13岁,平均月龄为52.51±38.35。入院在春季病例46例,夏季52例,秋季28例,冬季35例。城市儿童93例,农村儿童68例。不同疾病、性别、年龄、季节及城乡之间住院儿童CSF标本中的病毒检出率无统计学差异。 4.CSF标本病毒检出阳性病例与阴性病例之间临床症状与体征均无差异。病毒检出阳性与阴性病例之间辅助检查结果无统计学差异。 5.本组资料中检出的病毒平均载量为198.24±993.61copies/μL。检出的病毒载量与住院时间无显著相关。 6.EV检出病例多见于急性病毒性脑膜脑炎；以春夏季节多见；在3-6岁年龄段检出率最高。HHV-6检出病例多见于秋季；ADV阳性病例以农村患儿多见。MuV检出病例仅1例有腮腺肿大。12例检出MV的病例均无麻疹典型表现。结论 1.本研究期间内从长沙地区急性病毒性脑炎、脑膜炎及脑膜脑炎住院儿童CSF标本中检出10种常见病毒,检出率较前期研究略有上升,MV和MuV检出明显增多； 2.病毒检出阳性与阴性病例在性别、年龄、季节、城乡以及临床特征之间无差异； 3.急性病毒性脑炎检出病毒载量高于脑膜炎及脑膜脑炎的载量； 4.MuV、MV阳性检出病例各有其特点。
[Abstract]:Objective to observe the etiological composition of acute central nervous system virus infection in Changsha and provide reference for its prevention and treatment. Methods Enterovirus (EV), measles virus, (MV), mumps virus, (MuV), virus, (HPeV), encephalitis virus, (JEV), herpes simplex virus type 1 (HSV-1) were established. There are 11 real-time quantitative PCR (FQ-PCR) methods for detection of herpes simplex virus type 2 (HSV-2), adenovirus (ADV), varicella zoster virus (VZV), EB), (EBV), human herpesvirus 6 (HHV-6) and so on. CSF samples of hospitalized children with acute viral encephalitis, meningitis and meningoencephalitis were collected from Children's Medical Center of Hunan Provincial people's Hospital from October 2011 to July 2013. EV,MV,MuV,HPeV,JEV,HSV-1,HSV-2, was detected by FQ-PCR method. ADV,VZV,EBV,HHV-6 and other 11 common viruses. The epidemiological data and clinical features were analyzed by consulting relevant medical records and testing results. Result 1. The standard samples and standard curves of 11 viruses such as EV,MV,MuV,HPeV,JEV,HSV-1,HSV-2,ADV,VZV, EBV,HHV-6 were successfully constructed, and the detection method of FQ-PCR for these viruses was established. 2. During this study, 161 CSF specimens were collected from hospitalized children with acute viral encephalitis, meningitis and meningoencephalitis. 71 cases of virus were detected by FQ-PCR. The total detection rate was 44.10% (71 / 161). EV). The detection rate of MuV, was 8.07% (13 / 161), MV = 7.45% (12 / 161), EBV,HPeV was 4.97% (8 / 161), ADV = 3.73% (6 / 161). HHV-6 was 2.48% (4 / 161), JEV,HSV-1,HSV-2 was 0.62% (1 / 161), VZV. was not detected. Among the 3.161 hospitalized children, 82 cases were diagnosed as acute viral encephalitis, 20 cases as acute viral meningitis, 59 cases as acute viral meningoencephalitis. The average age was 52.51 卤38.35. 46 cases were admitted in spring, 52 cases in summer, 28 cases in autumn and 35 cases in winter. There were 93 urban children and 68 rural children. There was no significant difference in the detection rate of CSF among different diseases, sex, age, season and urban and rural children. There was no difference in clinical symptoms and signs between positive and negative 4.CSF specimens. There was no statistical difference between positive and negative cases. 5. The average viral load was 198.24 卤993.61copies/ 渭 L. There was no significant correlation between the viral load detected and the length of stay. 6.EV was more common in acute viral meningoencephalitis than in spring and summer, and was the highest in the age group of 3-6 years old. HHV-6 was more common in autumn. ADV positive cases were mostly found in rural children. Only 1 case with parotid gland enlargement was detected by MuV and 12 cases with MV had no typical manifestation of measles. Conclusion 1. Ten common viruses were detected in CSF samples of hospitalized children with acute viral encephalitis, meningitis and meningeal encephalitis in Changsha area during the study period. The detection rate was slightly higher than that in the previous study, and the detection rate of MV and MuV increased significantly; 2. There was no difference in sex, age, season, urban and rural areas and clinical features between positive and negative cases. The viral load of acute viral encephalitis was higher than that of meningitis and meningoencephalitis.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.1

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