逆转录多聚酶链反应对肠道病毒性脑膜炎、脑炎诊断价值探讨

• 作 者: 陈宗波 董永绥 方峰 黄志华 熊正明 李革
• 机 构: 山东省滨州医学院附属医院儿科,同济医科大学同济医院儿科教研室
• 出 处: 中国实用儿科杂志
• 发表日期: 1999年02期
• 关键词: 病毒性脑膜炎 肠道病毒 无菌性脑膜炎 病毒分离 价值探讨 急性期 标准毒株 斑点杂交 血清型鉴定 萨奇

目的探讨中枢神经系统感染的病原体及其检测方法。方法应用逆转录多聚酶链反应（ＲＴ－ＰＣＲ）检测６４例无菌性脑膜炎及２７例无菌性脑炎患儿脑脊液（ＣＳＦ）中肠道病毒（ＥＶ）ＲＮＡ。结果急性期ＣＳＦ中ＥＶＲＮＡ阳性检出率为：无菌性脑膜炎６０９％，脑炎４８１％；阳性患儿恢复期ＣＳＦ仅个别阳性；对照组全部阴性。起病５天以内阳性率明显高于５天以后（Ｐ＜００５）；５～１０月份较１１～４月份发病率高（Ｐ＜００５）。２５例病毒分离阳性者中２４例ＲＴ－ＰＣＲ阳性，５３例病毒分离阴性者中１９例ＲＴ－ＰＣＲ阳性，ＲＴ－ＰＣＲ敏感性显著高于病毒分离的敏感性（Ｐ＜００１）。结论ＥＶ是引起中枢神经系统感染的重要病原体，ＲＴ－ＰＣＲ技术是诊断ＥＶ感染的有效方法。

Objective To explore the pathogen of central nervous system infection and its detection method. Methods Sixty-four children with aseptic meningitis and 27 children with aseptic encephalitis (CSF) enterovirus (EV) RNA were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). Results The positive rate of EVRNA in acute CSF was 60.9% for aseptic meningitis and 48.1% for encephalitis. Positive CSF was only positive in convalescent stage and negative in control group. The positive rate within 5 days after onset was significantly higher than that after 5 days (P <005). The incidence rate was higher in May to October than in November to April (P <005). RT-PCR was positive in 24 out of 25 cases of virus-positive isolates, and RT-PCR in 19 of 53 out of 53 isolates was positive. The sensitivity of RT-PCR was significantly higher than that of virus isolation (P <001). Conclusion EV is an important causative agent of central nervous system infection. RT-PCR is an effective method to diagnose EV infection.