疱疹病毒性脑炎的早期诊断方法研究  

Early diagnosis of herpes viral encephalitis

作　　者：肖波[1,2,3] 侯熙德[1,2,3] 向传喜 彭隆祥[1,2,3] 金庆文[1,2,3] 许念桂 彭永 谢光洁[1,2,3] 

机构地区：[1]湖南医科大学附属湘雅医院神经内科 [2]湖南医科大学附属湘雅医院电子显微镜室 [3]南京医科大学附属第一医院神经内科

出　　处：《中华神经科杂志》1998年第6期336-338,共3页Chinese Journal of Neurology

摘　　要：目的探讨不同检测手段对早期诊断疱疹病毒性脑炎（ＨＶＥ）的价值。方法应用间接荧光抗体法（ＩＦＡ）、聚合酶链反应（ＰＣＲ）检测ＨＶＥ患者脑脊液中的抗疱疹病毒ＩｇＭ抗体和疱疹病毒核酸；应用免疫细胞化学（ＩＣＣ）、原位杂交（ＩＳＨ）和ＰＣＲ检测ＨＶＥ患者脑活检组织中的疱疹病毒抗原和核酸。结果６４例患者脑脊液中５４例抗疱疹病毒ＩｇＭ抗体阳性，５０例ＰＣＲ阳性，其中４０例两者均为阳性。１２例脑组织中１０例ＰＣＲ阳性，４例ＩＳＨ阳性，６例ＩＣＣ阳性。结论抗疱疹病毒ＩｇＭ抗体检测最敏感，以下依次为ＰＣＲ、ＩＣＣ、ＩＳＨ诊断疱疹病毒性脑炎，联合应用以上几种检测手段有助于提高早期诊断ＨＶＥ阳性率。Objective To study the value of different methods for the early diagnosis of herpes viral encephalitis (HVE). Methods With indirect fluorescent antibody assay (IFA), polymerase chain reaction (PCR), to detect viral antibody and DNA in cerebral spinal fluid (CSF), and with immunocytochemistry (ICC) and in situ hybridization (ISH), to detect viral antigen and DNA in the brain biopsy tissues. Results Among 64 CSF samples, 54 samples were positive with immunosluofescence assay(IFA), and 50 with PCR; 40 samples were positive with both methods. 10 samples were positive with PCR, 4 with ISH, and 6 with ICC from 12 brain biopsy samples. Conclusions IgM detection was the most sensitive to early diagnosis of HVE, and in the following order of sensitivity were PCR, ICC and ISH. Combining these methods were of use to improve the positive rate of early diagnosis of HVE.

关 键 词：脑炎 疱疹病毒性脑炎 疱疹病毒 脑活检 诊断 

分 类 号：R512.304[医药卫生—内科学]