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目的了解合肥地区儿童病毒性脑炎的病原构成及不同年龄组患儿临床表现差异。方法将53例病毒性脑炎患儿根据年龄分为A组(<3岁)、B组(3岁～6岁)及C组(>6岁)3组。(1)采用PCR法检测脑脊液常见病毒核酸,包括肠道病毒(EV)、单纯疱疹病毒(HSV)、水痘-带状疱疹病毒(VZV)和人巨细胞病毒(HCMV)。(2)分析不同年龄组临床表现特点。结果(1)32例核酸检测阳性(60.38%),其中EV 23例(43.40%),HSV 8例(15.09%),HCMV 1例(1.89%),未检出VZV。(2)A、B两组中有惊厥者明显多于C组(P<0.01),C组以头痛为早期症状者23例(85.19%),而A、B两组分别只有1例和4例(P<0.01)。HSV脑炎惊厥发生明显多于其他病毒性脑炎。结论证实合肥地区儿童病毒性脑炎病原以EV和HSV为主,HSV脑炎临床症状较严重,提示临床应加强病毒性脑炎病原检测工作,而PCFR检测患儿脑脊液中特异性病毒核酸片段符合临床快速、特异诊断要求。
Objective To understand the etiopathogenisis of children with viral encephalitis in Hefei and the difference of clinical manifestations in children of different age groups. Methods 53 children with viral encephalitis were divided into three groups according to their age: group A (age 3 years), group B (age 3 to 6 years) and group C (age 6 years). (1) The common cerebrospinal fluid viral nucleic acids, including enterovirus (EV), herpes simplex virus (HSV), varicella-zoster virus (VZV) and human cytomegalovirus (HCMV) were detected by PCR. (2) analyze the clinical manifestations of different age groups. Results (1) 32 cases of nucleic acid were positive (60.38%), including 23 cases of EV (43.40%), 8 cases of HSV (15.09%) and 1 case of HCMV (1.89%). No VZV was detected. (2) There were 23 cases (85.19%) with headache as early symptom in group A and group B (P <0.01), while those in group A and B only had 1 case and 4 Cases (P <0.01). HSV encephalitis convulsions occurred significantly more than other viral encephalitis. Conclusions Hepatitis encephalitis in children with EV and HSV is the main pathogen in Hefei. The clinical symptoms of HSV encephalitis are more serious, which suggests that the etiological diagnosis of viral encephalitis should be strengthened. However, the detection of specific virus nucleic acid fragments in cerebrospinal fluid Clinical rapid, specific diagnostic requirements.