小儿病毒性脑炎与抗病毒抗体IgM的临床意义  

IgM and its clinical significance of the acute viral encephalitis in children

作　　者：邵新华[1] 吴洁[1] 汪梅先[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心儿内科,上海200092

出　　处：《海南医学》2004年第9期50-51,38,共3页Hainan Medical Journal

摘　　要：目的　探讨小儿病毒性脑炎及其脑脊液抗病毒抗体IgM的临床意义。方法　应用酶联免疫吸附(ELISA)方法 ,对 95例临床诊断病毒性脑炎患儿急性期及恢复期脑脊液进行了单纯疱疹病毒 (HSV -Ⅰ ,HSV -Ⅱ )、柯萨奇B组病毒 (CoxBV)、埃可病毒 (ECHO)、EB病毒 (EBV)、腺病毒 (AdV)及流感病毒 (IFV)特异性IgM抗体检测。结果　HSV、CoxBV、ECHO、EBV、AdV、IFV病毒感染率分别为 9.47%( 9 95 )、18.95 %( 18 95 )、2 3 .16%( 2 2 95 )、3 .16%( 3 95 )、4.2 1%( 4 95 )、6.3 2 %( 6 95 ) ;脑脊液抗病毒抗体IgM的阳性率为 65 .2 6%( 62 95 ) ;HSV及EBV感染后遗症发生率及病死率分别为 77.78%( 7 9)和 66.67%( 2 3 )。结论　脑脊液中病毒特异性IgM抗体检测可作为早期病原诊断的指标之一 ;CoxBV及ECHO病毒是本地区小儿中枢神经系统病毒感染的主要病毒 ;HSV及EBV感染后遗症发生率及病死率较其它病毒高 ,预后不良 ;早期阿昔洛韦治疗 ,可大大降低后遗症发生率及病死率。Objective To study specific IgM with its clinical significance and clinical characteristics of viral encephalitis in children.Methods The specific IgM antibodies of herpes simplex viruses types 1 and 2(HSV-Ⅰ, HSV-Ⅱ),coxsackieviruses B(CoxBV),echoviruses(ECHO),Epstein-Barr viruses (EBV), adenovirus (AdV) and influenza viruses(IFV) were determined with enzyme-linked immunoassay(ELISA)in the cerebrospinal fluid (CSF) from 95 viral encephalitis cases.Results Showed that specific IgM antibodies to HSV; CoxBV, ECHO, EBV, AdV and IFV were Positive in 9. 47% (9/95),18. 95%(18/95),23. 16% (22/95),3.16%(3/95),4. 21% (4/95) and 6.32%(6/95) cases, respectively. The rate of detection of infection was 65.26% (62/95).Conclusions The detection of specific IgM antibodies is one of the ways to make early diagnosis of viral encephalitis .The CoxBV and ECHO were main viruses in the children with acute central nervous system infection in local area .The morbidity and mortality rates of HSV and EBV were 77.78%(7/9) and 66.67%(2/3) separately,and were higher than that of other viruses.The early identification of pathogen will be helpful to guide the treatment and improve the prognoses.

关 键 词：病毒性脑炎 病毒 IGM 儿童 

分 类 号：R512.3[医药卫生—内科学]