中山市2016-2018年急性脑炎脑膜炎症候群监测病例分析  

Acute meningitis and encephalitis syndrome,Zhongshan City,2016-2018

作　　者：蔡乾春[1] 陈小红[1] 谢颖[1] 王翠玲[1] 吕海英[1] 郑悦康[1] 王曼[1] CAI Qian-chun;CHEN Xiao-hong;XIE Ying;WANG Cui-ling;LV Hai-ying;ZHENG Yue-kang;WANG Man(Zhongshan Center for Disease Control and Prevention,Zhongshan,Guangdong 528403,China)

机构地区：[1]中山市疾病预防控制中心,广东中山528403

出　　处：《现代预防医学》2020年第17期3225-3227,3238,共4页Modern Preventive Medicine

基　　金：2016年中山市科学技术局科技计划项目(编号:2016B1059)。

摘　　要：目的分析2016-2018年中山市急性脑炎脑膜炎症候群(AMES)监测病例的流行特征及病原谱构成,为指导中山市急性脑炎脑膜炎防控及诊治提供依据。方法制定中山市AMES监测方案,通过实验室检测和描述流行病学分析AMES病例及病原学分布。结果AMES病例基本情况:1643例中,男、女性别比为1.6∶1。各年龄段均有病例,<15岁的病例占58.5%,其中<2岁的婴幼儿占24.2%,2~4岁组占21.4%;职业以散居儿童为主占42.2%;月份分布以3-7月为发病高峰,占53.7%。病原体阳性检出率11.1%,其中病毒类占69.4%,EB病毒最高(2.4%);细菌类占30.6%,肺炎链球菌和念珠菌最高(均0.9%)。病原体阳性率较高月份分别是:EB病毒1-5月,肠道病毒、单纯疱疹病毒、巨细胞病毒4-7月,肺炎链球菌11月。感染年龄分布:病毒感染阳性率较高为<5岁组;脑膜炎奈瑟菌和溶血性猪链球菌阳性率较高为>30岁组,大肠埃希菌阳性率较高的为<1岁。结论2016-2018年中山市AMES病例以低年龄组的散居儿童为主,以病毒类病例占多数,实验室确诊率偏低,应加强监测系统建设,以减少漏诊和误诊。Objective To provide basic data for the prevention and treatment of AMES in Zhongshan by analyzing the AMES surveillance cases in Zhongshan from 2016 to 2018.Methods AMES surveillance program was established,and all the AMES cases and pathogenic distribution were analyzed by laboratory tests and descriptive epidemiology.Results 58.5%of the cases were younger than 15 years old,24.2%of them were younger than 2 years old,21.4%of them were 2~4 years old.42.2%of the cases were scattered children,and 53.7%of them were from March to July.The positive rate of pathogens was 11.1%,of which 69.4%were viruses,2.4%were EBV,30.6%were bacteria,0.9%were Streptococcus pneumoniae and Candida.Pathogens tested positive peak as EBV 1-5 months,enterovirus,herpes simplex virus,cytomegalovirus 4-7 months,Streptococcus pneumoniae 11 months.Age distribution of infection:the virus infection was higher in<5-year-old group;the Neisseria meningitidis and hemolytic streptococcus suis infection was higher in>30-year-old group;the Escherichia coli infection was higher in<1-year-old group.Conclusion The AEMS cases in Zhongshan City are mainly scattered children of the low age group from 2016 to 2018.Most of the cases are viral cases and the laboratory diagnosis rate is low.Therefore,the construction of a monitoring system should be strengthened to reduce missed diagnosis and misdiagnosis.

关 键 词：急性脑炎脑膜炎症候群 监测系统 流行病学 病原谱 

分 类 号：R742[医药卫生—神经病学与精神病学] R181.3[医药卫生—临床医学]