肠道病毒71型致神经源性肺水肿的研究进展

发布时间：2019-04-16 20:22

【摘要】：肠道病毒71型（Enterovirus71，EV71）是手足口病（hand,foot and mouthdisease,HFMD）的主要病原体之一。近期，在亚洲儿童中，EV71已经引起了危及生命的大爆发流行，主要累及神经和心肺系统，但具体机制至今仍不明确。EV7l感染可导致全球性流行，四季均可致病，以夏秋季为发病高峰，潜伏期2～10天，平均3～5天。传染源包括患者、隐性感染者及健康带毒者。EV71主要通过消化道、呼吸道及直接接触患者鼻喉分泌液、唾液、水疱液、粪便等途径传播。此病多发生于5岁以内儿童，尤其是3岁以内婴幼儿，以手、足、臀部位皮肤及口腔粘膜的疱疹为典型表现，起病时多有发热，伴有咽部疼痛，大多数预后良好，少数病例可出现致命的神经系统、呼吸系统及循环系统并发症，如无菌性脑膜炎、脊髓灰质炎样麻痹、病毒性脑炎、神经源性肺水肿（neurogenic pulmonaryedema,NPE）及心肌炎。 EV71是目前最具有嗜神经性的肠道病毒（Enterovirus，EV），EV71感染最严重的并发症是NPE，NPE病程进展迅速、治疗困难、病死率高，对我国儿童健康造成了严重危害，由EV71感染所导致的NPE近年来受到人们的广泛关注，虽然临床报道很多，但其发病机制目前尚不十分清楚，另外，目前还没研制出相应的疫苗或抗病毒药物用于EV71引起的疾病的预防和治疗，因此，，针对EV71的基础研究对目前HFMD高发态势下的公共卫生形势来说显得十分迫切和意义重大。故本文通过对EV71的流行病学、病原学，EV71致NPE的发病机制、诊断、鉴别诊断及治疗作一系统论述，为EV71致NPE的研究提供参考。
[Abstract]:Enterovirus 71 (Enterovirus71,EV71) is one of the main pathogens of hand, foot and mouth disease (hand,foot and mouthdisease,HFMD). Recently, among Asian children, EV71 has caused a life-threatening outbreak, mainly involving the nervous and cardio-pulmonary system, but the specific mechanism is still unclear. EV 7l infection can lead to a global epidemic, and can cause disease throughout the four seasons. The peak of onset was summer and autumn, and the incubation period was 2-10 days (average 3-5 days). EV71 is mainly transmitted through digestive tract, respiratory tract and direct contact with nasal and laryngeal secretions, saliva, vesicular fluid, feces and so on. The disease usually occurs in children under 5 years of age, especially infants under 3 years of age. The typical manifestation of this disease is herpes in the skin and oral mucosa of the hands, feet, buttocks, and oral mucosa. Most of them have fever and sore pharynx when they start the disease, and most of them have a good prognosis. Fatal neurological, respiratory and circulatory complications such as aseptic meningitis, poliomyelitis, viral encephalitis, neurogenic pulmonary edema (neurogenic pulmonaryedema,NPE) and myocarditis can occur in a few cases. EV71 is the most neurotropic enterovirus (Enterovirus,EV) at present. The most serious complication of EV71 infection is the rapid progress of the course of disease, the difficulty of treatment and the high mortality of NPE,NPE, which has caused serious harm to the health of children in China. NPE, caused by EV71 infection, has received extensive attention in recent years. Although many clinical reports have been reported, the pathogenesis of NPE is still unclear. In addition, At present, the corresponding vaccines or antiviral drugs have not been developed for the prevention and treatment of EV71-induced diseases. Therefore, the basic research on EV71 is very urgent and significant to the public health situation under the situation of high incidence of HFMD. In this paper, the epidemiology, etiology, pathogenesis, diagnosis, differential diagnosis and treatment of EV71-induced NPE were systematically discussed in order to provide a reference for the study of EV71-induced NPE.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R725.1

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