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[目的]了解济南市急性脑炎、脑膜炎的病原学特征和流行病学特点。[方法]选择6所监测哨点医院,以临床诊断为急性脑炎、脑膜炎的病例为监测对象,收集有关病例信息,并采集血清和脑脊液标本,分别采用细菌培养、ELISA和RT-PCR(或PCR)等方法进行病原学检测。[结果]2006年9月至2009年12月,共报告1 207例;地区分布较分散;7～9月发病最多,不同月份发病情况差别具有统计学意义(P<0.01);男性发病多于女性,性别比为1.6∶1。以儿童为主,0～4岁和5～9岁发病率高;大中小学生、散居儿童、农民、托幼儿童为高发职业;最常见的临床表现是发热、呕吐、精神萎靡、恶心;乙脑阳性率为11.82%,其他病毒性脑炎/脑膜炎病例分离到的病原体最多的是肠道病毒、流腮病毒和单纯疱疹病毒;经实验室确诊的病例中,误诊率高达30.95%。[结论]济南急性脑炎、脑膜炎分布广泛,多为病毒引起,临床上存在一定的漏诊,应加强适龄儿童的疫苗注射及疾病监测。
[Objective] To understand the etiological and epidemiological characteristics of acute encephalitis and meningitis in Jinan City. [Methods] Six selected sentinel hospitals were selected and the cases of acute encephalitis and meningitis were clinically diagnosed as the monitoring subjects. Relevant case information was collected and serum and cerebrospinal fluid samples were collected. Bacterial culture, ELISA and RT-PCR Or PCR) and other methods for etiological testing. [Results] A total of 1 207 cases were reported from September 2006 to December 2009; the distribution was relatively scattered; the incidence was highest from July to September, and the difference was statistically significant in different months (P <0.01); the incidence of male was more than that of male Female, sex ratio was 1.6: 1. Mainly children, 0 to 4 years old and 5 to 9 years old with a high incidence; primary and secondary students, diasporas, peasants, nurseries for high occupational; the most common clinical manifestations are fever, vomiting, apathetic, nausea; The brain positive rate was 11.82%. The most common pathogens isolated from other viral encephalitis / meningitis cases were enterovirus, mumps virus and herpes simplex virus. The misdiagnosis rate was up to 30.95% in laboratory confirmed cases. [Conclusion] The acute encephalitis and meningitis in Jinan are widely distributed and are mostly caused by viruses. There are some misdiagnosis clinics in Jinan. Vaccination and disease monitoring of children should be strengthened.