2010年济南市急性脑膜炎/脑炎症候群病原学监测与分析  

Surveillance and Analysis on Etiology of Acute Meningitis/Encephalitis Syndrome in Jinan City of Shandong Province in 2010

作　　者：林小娟[1] 刘桂芳[1] 王敏[1] 宋立志[1] 李漫时[1] 张先慧[2] 徐胜平[2] 张岩[1] 熊萍[1] 陶泽新[1] 王海岩[1] 徐爱强[1] 

机构地区：[1]山东省疾病预防控制中心,山东省传染病预防控制重点实验室,济南250014 [2]济南市疾病预防控制中心,山东济南250001

出　　处：《中国疫苗和免疫》2012年第2期127-130,共4页Chinese Journal of Vaccines and Immunization

基　　金：国家"十一五"科学技术重大专项"病毒性传染病病原谱流行规律及变异研究"课题(编号:2009ZX10004-202);卫生部/世界卫生组织流行性脑脊髓膜炎和流行性乙型脑炎等疾病监测合作项目

摘　　要：目的了解济南市急性脑膜炎/脑炎症候群(Acute Meningitis/Encephalitis Syndrome,AMES)病原构成及流行病学特征。方法对2010年济南市6所哨点医院采集的AMES病例的血清和脑脊液(Cerebrospinal Fluid,CSF)标本,开展4种病毒免疫球蛋白(Immunoglobulin,Ig)M检测和3种细菌的荧光定量聚合酶链反应(Polymerase Chain Reaction,PCR)检测。结果 2010年共报告AMES病例611例,<15岁儿童占75.62%,男女性比例为1.94﹕1,7～9月为发病高峰。94.27%(576/611)的病例采集了血清和/或CSF标本,所有的血清和CSF标本均进行了流行性乙型脑炎病毒(Japanese Encephalitis Virus,JEV)抗体检测,阳性率为13.19%(76/576)。JEV IgM阴性的372份标本中,血清人类肠道病毒(Human Enterovirus,HEV)、单纯疱疹病毒(Herpes Simplex Virus,HSV)、流行性腮腺炎病毒(Mumps Virus,MuV)IgM的阳性率分别为37.90%、28.23%和13.44%。205份CSF标本荧光定量PCR检测结果为:5例C群脑膜炎奈瑟菌(Neisseria meningitidis,Nm)阳性,2例肺炎链球菌阳性,未检测到流行性感冒嗜血杆菌阳性病例。结论 2010年济南市哨点监测AMES病例的病原,HEV居首位,其次为HSV、MuV、JEV。同时发现一起3例C群Nm聚集性疫情。今后应加强AMES病例监测,特别是实验室病原学检测。Objective To investigate the etiology and epidemiological characteristics of the acute meningitis/encephalitis syndrome （AMES） in Jinan city. Methods Serum and cerebrospinal fluid （CSF） samples, collected from AMES cases from 6 sentinel surveillance hospitals of Jinan city in 2010, were examined for immunoglobulin （Ig） M antibody to 4 kinds of viruses by enzyme-linked immunosorbent assay （ELISA） and the presence of 3 kinds of bacteria by real-time fluorescent quantitative polymerase chain reaction （PCR）. Results 611 AMES cases were reported in 2010 and showed a peak from July to September. 75.62% AMES cases were children under 15 year-old and the ratio of male to female was 1.94 ：1. Serum and/or CSF were collected from 94.27 % （576/611 ） of AMES cases. All samples were examined for IgM antibody to Japanese encephalitis virus （JEV） and the positive rate was 13.19% （76/576）. For the samples with negative to JEV IgM, the positive rates for IgM antibody to human enterovirus （HEV）, herpes simplex virus （HSV） and mumps virus （MuV） from other 372 serum samples were 37.90%, 28.23% and 13.44%, respectively. And 5 cases with C group of Neisseria meningitidis （Nm）, 2 cases with streptococcus pneumoniae and no cases with haemophilus influenzae were also detected from other 205 CSF samples by PCR. Conclusion The AMES cases of Jinan city in 2010 were mainly caused by viruses in which HEV was the predominant pathogen followed by HSV, MuV and JEV. A cluster epidemic with 3 cases of group C Nm epidemic cerebrospinal meningitis was also found in this year. The surveillance, especially pathogenic diagnosis for AMES Cases should be enhanced in the future.

关 键 词：急性脑膜炎 脑炎症候群 病原学 监测 

分 类 号：R512.3[医药卫生—内科学]