小儿中枢神经系统单纯疱疹病毒感染的临床横断面研究  

Clinical cross sectional study on the central nervous system infection in children caused by herpes simplex virus

作　　者：杨天娇[1] 朱启鎔[1] 王晓红[1] 王建设[1] 

机构地区：[1]复旦大学附属儿科医院感染科,上海200032

出　　处：《临床儿科杂志》2006年第5期386-389,共4页Journal of Clinical Pediatrics

摘　　要：目的了解小儿中枢神经系统单纯疱疹病毒（HSV）感染的患病情况，并对其临床特点进行分析。方法收集2001年6月～2002年6月住院的中枢神经系统病毒感染患儿150例的脑脊液（cerebrospinal fluid，CSF）标本，应用套式PCR检测脑脊液中HSV．DNA及酶联免疫吸附法检测脑脊液中特异性HSV-IgM抗体。结果6例患儿脑脊液中HSV1-DNA（＋），另1例HSV1-IgM（＋），单纯疱疹病毒占中枢神经系统病毒感染的4．67％；呈散发性起病，无明显季节、年龄、性别分布特点，与其他病毒感染相比，惊厥持续状态、精神症状发生率高（P〈0．01），意识障碍、病死率差异无显著性。结论①单纯疱疹病毒感染占儿童中枢神经系统感染的4．67％，不是儿童病毒性脑炎的常见病原，呈散发性起病，无明显季节、性别、年龄分布特点；②儿童中枢神经系统单纯疱疹病毒感染多为HSV1的原发感染，可导致脑炎、脑干脑炎、急性播散性脊髓膜炎；③单纯疱疹病毒脑炎（herpes simplex virus encephalitis，HSE）起病较危重，出现精神症状较多，及时有效的抗病毒治疗能明显改善病情，降低病死率。Objective To investigate the prevalence and characteristics of herpes simplex virus infection （HSV） in the central nervous system （CNS） in children. Methods CSF was collected from 150 children with acute CNS viral infection （hospitalized from June 2001 to June 2002）. HSV DNA and HSV-specific IgM and IgG antibodies in CSF were detected with nested polymerase chain reaction （nested-PCR） techniques and enzyme-linked immunosorbert assays （ELISA） respectively. Results HSV1-DNA in CSF was positive in six patients. Whereas there was only one case with HSVI-IgM（ ＋ ） in the patients with HSV1-DNA（ - ）. The rate of HSV infection in patients with acute CNS viral infection was 4.67%. HSV infection in CNS was sporadic without obvious difference in distribution of season, age and gender. The incidence of status convulsivus and mental symptoms in HSV infection was higher than that in other virus infection （P〈0.01）, but there were no significant differences between HSV infection and other acute virus infection in disturbance of consciousness and mortality （P〉0.05）. Conclusions The incidence of HSV infection in patients with acute CNS viral infection is 4.67%. Most of HSV infections in CNS in children are caused by HSV1 primary infection and is very serious with high incidence of mental symptoms. Effective antiviral therapy can improve its recovery and decrease its mortality.

关 键 词：中枢神经系统 单纯疱疹病毒 临床研究 

分 类 号：R748[医药卫生—神经病学与精神病学]