788例疑似中枢神经系统感染病例相关病毒IgM抗体检出率的统计分析  

Analyzing the Positive Rate of Virus-specific Ig M Antibodies in 788 Patients Suspected of Being Central Nervous System Infections

作　　者：柏景乔[1] 刘宠[1] 张国军[1] 康熙雄[1] 

机构地区：[1]首都医科大学附属北京天坛医院检验科北京市免疫试剂临床工程技术研究中心,北京100050

出　　处：《标记免疫分析与临床》2015年第9期825-829,共5页Labeled Immunoassays and Clinical Medicine

基　　金：北京市标记免疫分析试剂研发与临床评价工程技术研究中心2012年阶梯计划项目--北京市科委科技创新基地培育与发展工程(Z121102009212061)

摘　　要：目的统计分析2013年8月至2015年2月天坛医院神经内科门诊及住院患者中疑似中枢神经系统病毒感染病例的血清及脑脊液(cerebrospinal fluid,CSF)标本的病毒Ig M抗体检出情况。方法采用描述性流行病学方法对上述脑脊液及血清标本中的病毒Ig M抗体检出率差异进行统计分析。结果 1血液标本中,病毒抗体检出率由高到低依次为EB病毒(Epstein-Barr virus,EBV)抗体、单纯疱疹病毒(herpes simplex virus,HSV)抗体和风疹病毒(rubella virus,RUB)抗体,检出率分别为6.0%、5.2%和2.2%,余下病毒抗体检出率约为1%。而脑脊液中检出率最高的为HSV抗体,为4.7%,占所有检出抗体的92.5%。2病毒抗体在血清中检出率高于在其对应的脑脊液中。统计表明:单纯疱疹病毒抗体在血清中检出例数高于其在对应的脑脊液样本,差异具有统计学意义(P<0.01)。同样,相比脑脊液标本,在血清中EB病毒和柯萨奇病毒Ig M抗体检出率也较高,其P值分别为P<0.01和0.039。3病毒抗体检出以春、秋、冬三季多见,夏季检出率相对较低。4不同年龄段的患者病毒抗体检出率无差别。结论单纯疱疹病毒仍是我院疑似中枢神经系统病毒感染病例的主要病原体,该病毒Ig M抗体在患者血液和脑脊液中均具有较高的检出率。该病毒在血液标本中的检出率仅次于EB病毒。以上两种病毒是引起中枢神经系统感染的主要病毒,临床诊断中需引起足够的重视。Objective To analyze the virus IgM situation in serum and cerebrospinal fluid of neurology patients with suspected acute central nervous system （CNS） symptoms in Tiantan Hospital from August 2013 to February 2015, and to elucidate the current etiologic spectrum. Methods 788 eerebrospinal fluid （CSF） and corresponding serum samples from outpatients and inpatients suspected of being intracranial infection were detected to find virus-specific and toxoplasma gondii-specifie IgM antibodies by using enzyme-linked immunosorbent assay （ELISA） and electrochemiluminescence immunoassay （ECLIA）. The positive results of these specific IgM antibodies were compared between serum and CSF samples using the chi-square test. Results Epstein-Barr virus （EBV） got the highest IgM detection rate in serum, followed by herpes simplex virus （HSV） and rubella virus （RUB） antibodies with detection rate 6.0% ,5.2% and 2.2% respectively. For the rest virus and toxoplasma gondii, the antibodies detection rates were about 1% in serum. In cerebrospinal fluid, however,the majority of the IgM was HSV antibody, its detection rate was 4.7%, about 92.5% of all detectable antibodies. The detection rate of virus-specific IgM antibodies was higher in serum than in the cerebrospinal fluid. The detection rate of HSV antibodies in serum samples was higher than their corresponding CSF samples, with a statistically significant difference between these two groups （P 〈 0.01, chi-square test）. Similarly, compared to CSF group, the IgM antibodies of EB virus and coxsackie virus （Cox V） also showed a higher detection rate in serum with the statistically significant difference （ P 〈 O. O1 and P = 0. 039 ）. For seasonal distribution,the CNS virus infection mainly occurred in spring, autumn and winter. The infection rate for different age groups had no significant difference. Conclusion Herpes simplex virus may be the main pathogens in patients suspected of being intracranial infection. In serum, EBV has the highest IgM de

关 键 词：神经系统感染 病毒性感染 流行病学调查 

分 类 号：R741[医药卫生—神经病学与精神病学] R446.62[医药卫生—临床医学]