病毒性脑炎患儿脑脊液人类鼻病毒检测的价值  

Value of Human Rhinovirus Detected in Cerebrospinal Fluid of Children with Viral Encephalitis

作　　者：高珺[1] 王琼[2] 林广裕[3] 陈洁玲[3] 陆学东[2] 

机构地区：[1]广东医学院,广东湛江524023 [2]广东医学院附属福田医院医学检验部,广东深圳518033 [3]汕头大学医学院第二附属医院儿科,广东汕头515041

出　　处：《现代检验医学杂志》2015年第2期11-15,共5页Journal of Modern Laboratory Medicine

摘　　要：目的：了解儿童病毒性脑炎的病原体，建立快速、特异检测鼻病毒的方法，探讨病毒性脑炎与鼻病毒的相关性。方法收集2012年1月～12月全年期间收住在汕头大学医学院第二附属医院儿科重症监护室出现发热、惊厥症状的患儿脑脊液标本169份，应用巢式 RT-PCR 扩增脑脊液标本的鼻病毒核酸，对阳性结果进行核酸序列测定和同源性分析。结果巢式 RT-PCR 总共检测出39份鼻病毒阳性样本，总阳性检出率为23.1％；人类鼻病毒（HRV）感染的儿童中年龄在5岁以下的占87.6％；7～9月份 HRV 阳性检出率较高；序列分析显示39例 HRV 检测阳性标本中 HRV-A 型18例（46.1％，18／39），HRV-B 型7例（17.9％，7／39），HRV-C 型14例（35.9％，14／39）；28例病毒性脑炎有 8例检出 HRV，其中3例为HRV-C。结论建立的巢式 RT-PCR 可以检测到脑脊液标本中的鼻病毒片段，并且 HRV-A，B 和 C 三型均有检出，结合临床症状可认为 HRV 可能是病毒性脑炎的病原体之一。Objective To understand the pathogen of viral encephalitis（VE）in children,and establish a rapid and specific method for detecting human rhinovirus（HRV）,and investigate the correlation between HRV and viral encephalitis（VE）. Methods 169 CSF specimens were collected from children with convulsions and fever,who were admitted to the pediatric intensive care unit （PICU）of Second Affiliated Hospital of Shantou University Medical College between January 2012 and December 2012.Nested RT-PCR was used to detected HRV in CSF specimens,and the positive PCR products were sequenced,then analyzed and constructed the phylogenetic tree by software.Results 39 （23.1%）out of 169 samples were HRV positive.Among them,148（87.6%）children were below 5 years old.The detection rate of HRV increases from July to September,and reached its highest point in September.Sequence analyzed showed that the 39 HRV positive specimens including 18（46.1%,18/39）positive for HRV-A,7（17.9%,7/39）positive for HRV-B,14（35.9%,14/39）positive for HRV-C. There were 8 out of 28 VE cases were detected in HRV,including 3（50%,3/6）positive for HRV-C.Conclusion HRV could be detected in CSF specimens by nested RT-PCR,including three types of HRV,combined with clinical symptoms considered that HRV may be one of the VE pathogen.

关 键 词：鼻病毒 病毒性脑炎 儿童 巢式逆转录聚合酶链反应 

分 类 号：R512.3[医药卫生—内科学] R373.19[医药卫生—临床医学]