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目的分析龙岩市病毒性脑炎的流行特征及肠道病毒感染情况,为防控和临床诊治积累经验。方法对2011年发生的病毒性脑炎131例开展个案调查,对其脑脊液标本进行病毒分离、中和试验和病原确认。结果病毒性脑炎发病具有明显季节性,6、7月为发病高峰。131份标本肠道病毒阳性26株(19.8%),均为埃可病毒(ECHO);型别为ECHO30、ECHO 6和ECHO 11,以ECHO 30为常见血清型。临床上,患者多有发热、头痛和呕吐等症状,且以中高热为主,部分表现为咳嗽、腹痛、腹泻及皮疹等;大部分脑脊液外观正常,压力增高,白细胞增多,糖和氯化物基本正常。有63.9%的病例脑电图异常,76.0%的病例头部MRI异常。结论病毒性脑炎肠道病毒的主要型别有一定规律,新型肠道病毒传入或病毒发生变异,可发生感染或发病。因此,必需加强对肠道病毒的进一步监测。
Objective To analyze the epidemic characteristics of viral encephalitis and the infection of enteroviruses in Longyan City and to gain experience for the prevention, control and clinical diagnosis and treatment. Methods Thirty-one cases of viral encephalitis in 2011 were investigated. Virus isolation, neutralization test and pathogen identification of cerebrospinal fluid samples were performed. Results The incidence of viral encephalitis was significantly seasonal, peak incidence in June and July. Totally, 131 samples were positive for Enterovirus (19.8%), all of which were ECHO. The genotypes were ECHO30, ECHO 6 and ECHO 11, and ECHO 30 was the most common serotype. Clinically, patients with fever, headache and vomiting and other symptoms, and mainly in the high fever, part of the performance of cough, abdominal pain, diarrhea and rash; most of cerebrospinal fluid normal appearance, increased pressure, increased leukocytes, basic sugar and chloride normal. There were 63.9% cases of EEG abnormalities, 76.0% cases of head MRI abnormalities. Conclusion The main types of viral encephalitis enterovirus have certain rules, new enterovirus or virus mutation, infection or disease may occur. Therefore, further monitoring of enteroviruses needs to be strengthened.