不伴腮腺炎症的腮腺炎病毒性脑膜脑炎患儿临床分析  

Clinical analysis of mumps meningoencephalitis in children without parotitis

作　　者：林创兴[1] 陆学东[2] 林广裕[1] 蔡志伟[1] 蔡晓莹[1] 

机构地区：[1]汕头大学医学院第二附属医院儿科,515041 [2]深圳市第四人民医院检验科,518033

出　　处：《中华实用儿科临床杂志》2017年第22期1702-1704,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：广东省高水平大学重点学科建设“感染性疾病研究与防治”项目.

摘　　要：目的探讨儿童不伴腮腺炎症的腮腺炎病毒性脑膜脑炎的发病率及其临床特点。方法收集2010年6月至2016年2月因病毒性脑炎入住汕头大学医学院第二附属医院儿科的患儿脑脊液标本223份。应用PCR技术对腮腺炎病毒和麻疹病毒进行检测，对腮腺炎病毒阳性标本应用PCR方法检测总肠道病毒、肠道病毒71型、柯萨奇A16型病毒、登革热病毒、乙型脑炎病毒、风疹病毒、单纯疱疹病毒、巨细胞病毒、EB病毒、基孔肯雅病毒和黄热病病毒，分析腮腺炎病毒阳性病例的临床资料。结果223份脑脊液标本中，检出腮腺炎病毒11例（检出率4．9％），阳性标本中均未检出其他病毒、细菌、真菌和结核。11例腮腺炎阳性病例中，1例在入院第6天出现右侧腮腺肿痛；10例不伴腮腺炎症，占全部标本的4．5％。不伴腮腺炎症的腮腺炎病毒性脑膜脑炎患儿的主要症状是发热、头痛、呕吐和抽搐，脑脊液常规、生化、头颅磁共振成像、脑电图结果与普通病毒性脑炎类似，患儿总体预后良好，但脑脊液恢复正常时间较长，最长达到4周。结论儿童腮腺炎病毒性脑膜脑炎可以不伴腮腺炎症，其最常见的表现是发热、头痛、呕吐和抽搐。Objective To explore the morbidity and clinical characteristics of mumps meningoencephalitis in children without parotitis. Methods Two hundred and twenty - three cerebrospinal fluid （CSF） specimens were co- llected from children who were diagnosed as viral encephalitis at Department of Pediatrics ,the Second Affiliated Hospi- tal of Shantou University Medical College from June 2010 to February 2016. Multiplex PCR was applied to detect the mumps virus,and other common viral, including measles virus, enterovirus, enterovirus 71 type, coxsackie virus A16 type, dengue virus, Japanese encephalitis virus, rubella virus, herpes simplex virus, human cytomegalovirus, Epstein - Barr virus, Chikungunya virus and Charon evagatus in mumps virus positive specimens were detected by PCR. The clini- cal data of patients with mumps virus infection were analyzed. Results In 223 CSF specimens, positive mumps virus were detected in 11 cases （4.9%）, of whom, the mycobacterial, fungal, conventional CSF cuhures and other common viral cause in CSF were negative. One case presented parotitis on the sixth day after admission. Of 11 cases with positive mumps virus ,there were 10 eases without parotitis. The cardinal symptoms of mumps meningoencephalitis in children without parotitis were fever, headache, vomiting and seizures, and the CSF parameters, brain magnetic resonance ima- ging, electroencephalogram of the patients were all similar to other viral encephalitis, while the prognosis was good in children with mumps meningoencephalitis without parotitis, but the CSF return to normal needed a long time, the longest time up to 4 weeks. Conclusion Mumps meningoencephalitis may occur in children without parotitis, and the most common symptom are fever.headache.vomiting and seizures.

关 键 词：腮腺炎病毒 病毒性脑炎 腮腺炎 儿童 

分 类 号：R725.1[医药卫生—儿科]