中枢神经系统病毒及弓形虫感染血清学特征分析  

Analysis of the Serological Features of Virus and Toxoplasma Infection in Central Nervous System

作　　者：柏景乔[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,北京市100050

出　　处：《中国全科医学》2015年第29期3566-3569,共4页Chinese General Practice

基　　金：北京市科技专项(Z121102009212061)--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年度阶梯计划项目

摘　　要：目的通过分析疑似中枢神经系统病毒及弓形虫感染患者血清学特点,为临床监测病原体和治疗提供依据。方法选取2013年8月—2015年3月于首都医科大学附属北京天坛医院治疗的疑似中枢神经系统病毒及弓形虫感染患者233例为疑似感染组。另于同期选取癫痫、脑出血、周围神经病及不明原因的抽搐、眼肌震颤和意识障碍为主要临床表现的其他神经系统疾病患者778例(其他神经系统疾病组)和体格检查健康、无疫区生活史的适龄孕妇91例作为对照。检测单纯疱疹病毒(HSV)、巨细胞病毒(CMV)、EB病毒(EBV)、风疹病毒(RUB)、弓形虫(TOX)的Ig M和Ig G抗体及柯萨奇病毒(COX)Ig M抗体,比较各组别抗体检出率的差异。结果健康孕妇组血清检出RUB Ig M抗体3例(3.3%)及CMV Ig M抗体1例(1.1%);其他神经系统疾病组血清Ig M抗体检出率以HSV-1/HSV-2(41例,5.3%)和EBV(32例,4.1%)较高;疑似感染组血清Ig M抗体检出率以HSV-1/HSV-2(15例,6.4%)、EBV(13例,5.6%)和RUB(12例,5.2%)较高。各组RUB Ig M抗体检出率比较,差异有统计学意义(P<0.05),其中疑似病例组RUB Ig M抗体检出率高于其他神经系统疾病组(χ2=8.034,P=0.005)。健康孕妇组血清Ig G抗体检出率以CMV(82例,90.1%)、RUB(76例,83.5%)、HSV-1(75例,82.4%)较高;其他神经系统疾病组血清Ig G抗体检出率以CMV(753例,96.8%)、RUB(662例,85.1%)、EBV(653例,83.9%)及HSV-1(632例,81.2%)较高;疑似感染组血清Ig G抗体以CMV(221例,94.8%)、EBV(211例,90.6%)、RUB(196例,84.1%)、HSV-1(182例,78.1%)较高。各组CMV Ig G抗体检出率比较,差异有统计学意义(P<0.05);其中其他神经系统疾病组CMV Ig G抗体检出率高于健康孕妇组(P=0.006)。疑似感染组EBV Ig G抗体检出率高于其他神经系统疾病组,差异有统计学意义(P<0.05)。结论 HSV、RUB、CMV以及EBV在人群中普遍易感,RUB可能更易引起临床急性感染症状。Objective To explore the serological features of patients suspected with virus and toxoplasm infection in central nervous system,in order to provide references for the clinical monitoring of pathogens and treatment. Methods We enrolled 233 patients suspected with virus and toxoplasm infection in central nervous system who received treatment in Beijing Tiantan Hospital,Capital Medical University from August 2013 to March 2015 as suspected infection group. And 778 patients who had epilepsy,cerebral hemorrhage,peripheral neuropathy and other neurological diseases with convulsion with unknown cause,tremble of musculi oculi and disturbance of consciousness as main clinical manifestations and 91 healthy pregnant women of right age and without living experience in epidemic areas as control. The Ig M and Ig G antibody of HSV, CMV, EBV, RUB andTOX,Ig M anti body of COX,were examined,and comparison was made among each group in the detection rate of antibody.Results In the group of healthy pregnant women,RUB Ig M was detected in 3（ 3. 3%） patients and CMV Ig M was detected in1（ 1. 1%） patient; in the group of other neurological diseases,Ig M antibody had a higher detection rate of HSV-1 / HSV-2（ 41,5. 3%） and EBV（ 32,4. 1%）; in suspected infection group,Ig M antibody had a higher detection rate of HSV-1 /HSV-2（ 15,6. 4%）,EBV（ 13,5. 6%） and RUB（ 12,5. 2%）. The three groups were significantly different in the detection rate of RUB Ig M antibody（ P〈0. 05）,with suspected infection group higher than the group of other neurological diseases in the detection rate of RUB Ig M antibody（ χ2= 8. 034,P = 0. 005）. In the group of healthy pregnant women,the Ig G antibody had a higher detection rate of CMV（ 82,90. 1%）, RUB（ 76,83. 5%） and HSV-1（ 75,82. 4%）; in the group of other neurological diseases,Ig G antibody had a higher detection rate of CMV（ 753,96. 8%）,RUB（ 662,85. 1%）,EBV（ 653,83. 9%） and HSV-1（ 632,81. 2%）; in the suspected infection group,Ig G antibody had a hi

关 键 词：中枢神经系统病毒感染 单纯疱疹病毒属 柯萨奇病毒感染 EB病毒 弓形虫 巨细胞病毒 风疹病毒 抗体 

分 类 号：R511[医药卫生—内科学] R741[医药卫生—临床医学]