病毒性脑炎的诊断及博尔纳病病毒p24基因片段的检测  

Diagonosis of VE and Detection of Borna Disease Virus p24 Gene Fragment in PBMCs in Patients with Viral Encephalitis

作　　者：马彦[1] 王振海[1] 孔繁元[1] 

机构地区：[1]宁夏医科大学附属医院神经内科,银川750004

出　　处：《宁夏医科大学学报》2009年第2期180-182,185,共4页Journal of Ningxia Medical University

基　　金：2006年国家"863"计划项目(2006AA02Z196);2007年国家自然科学基金面上项目(30760067);2007年宁夏自然科学基金项目(NZ0790);2007年第四十二批中国博士后科学基金项目(20070420721)

摘　　要：目的探讨脑脊液(CSF)、脑电图(EEG)、MRI对于病毒性脑炎的诊断价值,并检测病毒性脑炎患者外周血单个核细胞(PBMCs)中博尔纳病病毒(BDV)p24基因片段,探讨病毒性脑炎与BDV感染的关系。方法回顾性分析病毒性脑炎患者的CSF、EEG、MRI的阳性检出率并进行比较,用荧光定量巢式逆转录聚合酶链反应(FQ-nRT-PCR)方法检测病毒性脑炎患者及对照者PBMCs中BDVp24基因片段,并总结阳性患者的临床特征。结果CSF、EEG、MRI检查结果比较,CSF高于MRI检查结果阳性率(χ2=9.6,P<0.01);CSF高于EEG检查结果阳性率(χ2=7.58,P<0.01);MRI检查阳性率高于EEG(χ2=5.82,P<0.01)。PBMCs中BDVp24基因片段检测结果显示实验组4例阳性,对照组均为阴性。4例BDVp24基因片段阳性患者主要以发热、头痛、颅内压增高症状为主。结论脑脊液、MRI对病毒性脑炎的诊断价值优于EEG,部分病毒性脑炎的发生与BDV感染有关,主要以发热、头痛、颅内压增高为临床特征。Objective To explore the value of CSF,EEG,skull MRI for diagonosis of VE and detect Boma disease virus p24 gene fragment from peripheral blood mononuelear eells（PBMCs） of the patients with VE, and to discuss clinical features of patients infected by BDV and relations between BDV and VE. Methods 59 inpatients with VE were reviewed for their CSF, EEG, skull MRI result, retest CSF, EEG, skuU MRI respectively . The p24 gene fragment of BDV in PBMCs in these patients were examined by nested reverse transcriptase polymerase chain eaction （RT-PCR）and fluorescence quantitative （FQ） PCR, at the same time, the control group was examined too. The linical characteristics of positive patients infected by BDV were summarized. Results Positive rate based on CSF was significantly higher than that based on MRI, EEG respectively （ P 〈 0.01）. Skull MRI was significantly higher than EEG（ P 〈 0.01 ） . The number of the positive sample of BDV p24 gene fragment was 4 in experimental group （8）, and there were no positive patients in control group. The positive rate was significantly higher than that in control groups（ P 〈 0.05 ）. The clinical features of 4 intracranial infection patients infected BDV were mainly fever, headache and intracranial hypertension. Other clinical features were the same as viral encephalitis. Conclusion CSF and skull MRI is better than EEG for the diagonosis of VE . The results suggest that BDV infection possibly exists in the patients with VE in the city of Ningxia province. The clinical features of patients infected BDV were mainly fever,headache and intracranial hypertension.

关 键 词：病毒性脑炎 脑脊液 博尔纳病病毒 荧光定量巢式逆转录聚合酶链反应 

分 类 号：R512.3[医药卫生—内科学] R450[医药卫生—临床医学]