30例流行性乙型脑炎流行病学及临床特征分析  

Epidemiological and clinical features of 30 cases of epidemic encephalitis type B

作　　者：崔晨蓉[1] 王冯滨[1] 欧强[1] 

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心感染科,上海201508

出　　处：《微生物与感染》2009年第3期162-164,共3页Journal of Microbes and Infections

摘　　要：回顾性分析我中心感染科确诊的30例流行性乙型脑炎住院患者临床资料,分析流行性乙型脑炎的流行病学特征和临床特点,提高临床医师对该病的诊疗水平。结果显示,各年龄组人群均可发病,但儿童发病率较高。夏、秋季多发,集中在7?9月份,占全年病例的90%以上。所有患者均有发热、颅内高压症状,21例(70.0%)有意识障碍,14例(46.7%)出现抽搐,8例(26.7%)出现呼吸衰竭。脑膜刺激征阳性20例(66.7%),病理征阳性18例(60.0%)。脑脊液检查蛋白增高,白细胞计数均在300×106/L以下,糖和氯化物基本正常。脑脊液乙型脑炎特异性IgM抗体阳性率为100%。23例治愈或好转出院(76.7%),4例(13.3%)病情加重而自愿出院,3例(10.0%)治疗无效死亡。乙型脑炎仍是夏、秋季常见的中枢神经系统感染性疾病,流行区的儿童和青少年是易感人群。血液和脑脊液乙型脑炎特异性IgM抗体检查可明确诊断,对症支持治疗是治疗的关键。The goal of the current study was aimed to examine the epidemiological and clinical features of epidemic encephalitis type B and to improve the levels of diagnosis and treatment： The clinical data of 30 patients with epidemic encephalitis type B were analyzed retrospectively. Although all people are susceptible to this disease, children were more easily affected. More than 90% of the eases occurred in summer and autumn. All patients presented with fever and intraeranial hypertension. Twenty-one patients （70. 0% ） experienced a conscious disturbance. Fourteen patients （46. 7% ） presented with a tic and 8 patients （26.7%） experienced respiratory failure. Signs of meningeal irritation were positive in 20 cases and pathological signs were positive in 18 eases. The level of protein was high and leukocyte count was below 300 × 10^6/L in cerebrospinal fluid. The contents of chloride and glucose were normal. The positive rate of epidemic encephalitis type B-specific IgM antibody in cerebrospinal fluid was 100%. Twenty-three cases were cured or improved （76.7%）, 4 eases voluntarily discharged against medical advice（ 13.3% ） and 3 patients died （ 10. 0% ）. The results showed that epidemic encephalitis type B was most common in summer and autumn and that children and adolescents in epidemic areas were most susceptible. A correct diagnosis of epidemic encephalitis type B can be made by detecting specific IgM antibody in cerebrospinal fluid and blood. Symptomatic and supportive treatments are key parts of therapy.

关 键 词：流行性乙型脑炎 流行病学 诊断 治疗 

分 类 号：R512.3[医药卫生—内科学] R181.3[医药卫生—临床医学]