肠道病毒相关小儿病毒性脑炎病原谱及分子流行病学特征分析

发布时间：2018-06-07 16:01

本文选题：病毒性脑炎 + 肠道病毒　；参考：《中国妇幼保健》2014年22期

【摘要】：目的:探讨肠道病毒(HEV)相关小儿病毒性脑炎病原谱及分子流行病学特征,为临床治疗提供依据。方法:选取2010年1月~2012年12月珠海市各监测点中的样本,患儿均疑似患病毒性脑炎。病毒株均采用WTO《病毒试验室操作手册》检测,脑脊液或粪便0.2 ml接种RD细胞,操作步骤按说明书进行。结果:观察的545份样本中,分离到HEV115株,分离率为21.1%。在375份脑脊液样本中,分离HEV 72株,分离率为19.2%;在170份粪便样本中,分离HEV 43株,分离率为25.3%。分离的115株病毒共涉及12个血清型,CVB3-5、E25和E30在近3年中均有检出,且分离株最多,为绝对优势株。9例同时采集脑脊液和粪便样本的患儿中,有7例在两类样本均分离到同一血清型病毒,CVB3和CVB5各2例,两组比较,差异无统计学意义(P0.05);住院天数比较,差异有统计学意义(P0.05);PICS评分比较,差异有统计学意义(P0.05);综合疗效比较,差异有统计学意义(P0.01)。测序株各血清型内nt和aa同源性分别为79.3%~99.8%和89.1%~99.9%,与各原型株的nt和aa的同源性分别为79.1%~99.90%和88.4%~99.8%。结论:由于病原体的基因重组和变异,易使其致病病原改变,各地医务工作者对于HEV的基因变异应做好高度的准备,以防范各地的病毒性脑炎的暴发。
[Abstract]:Objective: To investigate the pathogenic spectrum and molecular epidemiological characteristics of enterovirus (HEV) related viral encephalitis in children, and to provide a basis for clinical treatment. Methods: samples from every monitoring site in Zhuhai in January 2010, ~2012, December, were suspected to be infected with viral encephalitis. The virus strains were detected by the operation manual of WTO< virus test room, cerebrospinal fluid or feces. After 0.2 ml inoculation of RD cells, the operation steps were carried out according to the instructions. Results: in the 545 samples of the observation, the HEV115 strain was isolated, the separation rate was 21.1%. in 375 CSF samples, 72 isolates were isolated and the separation rate was 19.2%; 43 HEV isolates were isolated in 170 fecal samples and 12 serotypes, CVB3-5, E2 isolated with the separation rate of 25.3%. were involved. 5 and E30 were detected in the last 3 years, and the isolates were the most. Among the children with.9 and fecal samples, 7 of the two samples were separated to the same serotype virus, 2 cases of CVB3 and CVB5, and the two groups were not statistically significant (P0.05), and the difference was statistically significant (P0.05); PICS The difference was statistically significant (P0.05), and the difference was statistically significant (P0.01). The homology of NT and AA in the serotypes of the sequenced strains was 79.3%~99.8% and 89.1%~99.9% respectively, and the homology of NT and AA in the prototypes was 79.1%~99.90% and 88.4%~ 99.8%., respectively: because of the recombinant and mutation of the pathogen, it was easy to make the mutation of the pathogen. The change of its pathogenic bacteria, medical workers everywhere should be highly prepared for the genetic variation of HEV, so as to prevent the outbreak of viral encephalitis.
【作者单位】：广东省珠海市第二人民医院;
【分类号】：R725.1;R181.3

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