2018年石家庄市及周边地区儿童病毒性脑炎及脑膜炎病原学研究  

Pathogen spectrum of viral encephalitis and meningitis in children in Shijiazhuang city and surrounding areas in 2018

作　　者：樊涛[1] 胡川泽 韩彦洁[1] 权会丽[1] 孙一硕 马静 于盼辉 谢正德[4] 王巍[4] 张萌[4] 乔彦霞[1] 孙素真[2] 陈祥鹏[4] Fan Tao;Hu Chuanze;Han Yanjie;Quan Huili;Sun Yishuo;Ma Jing;Yu Panhui;Xie Zhengde;Wang Wei;Zhang Meng;Qiao Yanxia;Sun Suzhen;Chen Xiangpeng(The Fourth Hospital of Shijiazhuang,Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University,Shijiazhuang 050000,China;Hebei Children′s Hospital Affiliated to Hebei Medical University,Shijiazhuang 050031,China;Affiliated Jinhua Hospital zhejiang University School of Medicine,Jinhua City Municipal Central Hospital,Jinhua 321000,China;Beijing Children′s Hospital,Capital Medical University,Beijing 10045,China)

机构地区：[1]石家庄市第四医院河北医科大学附属妇产医院,050000 [2]河北医科大学附属河北省儿童医院,石家庄050031 [3]浙江大学医学院附属金华医院金华市中心医院,金华321000 [4]首都医科大学附属北京儿童医院,北京100045

出　　处：《中华实验和临床病毒学杂志》2021年第5期566-569,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：十三五传染病重大专项课题(2018ZX10713002);河北省重点研发计划自筹项目(182777153);中国医学科学院医学与健康科技创新工程项目(CIFMS 2019-I2M-5-026)。

摘　　要：目的探讨石家庄市及周边地区儿童病毒性脑炎及脑膜炎的病原学特点,同时研究病原学与临床表现之间的联系。方法随机收集石家庄市及周边地区于河北省儿童医院神经内科诊断为病毒性脑炎及脑膜炎(2018年1~12月)的住院患儿脑脊液标本132例,应用实时荧光定量PCR方法对脑脊液中的4种病毒核酸进行检测。采用SPSS 21.0软件进行统计学分析。结果132例患儿中男性78例,女性54例,男女性别比为1.44∶1。各年龄组的性别构成不具统计学差异(χ^(2)=3.901,P=0.272)。132例患儿中,发热体征的121例、头痛症状的109例、呕吐症状的92例、脑电图(electroencephalogram,EEG)异常的17例、头部磁共振(magnetic resonance imaging,MRI)异常15例。病毒被检出的80例,77例为肠道病毒(enterovirus,EV),有2例为水痘-带状疱疹病毒(varicella-zoster virus,VZV),1例为人疱疹病毒I型(human herpesvirus type I,HHV-I)。其中1~3岁年龄组EV检出率为66.67%,4个年龄组(<1岁、1~3岁、3~6岁、>6岁)的EV检出率无显著差异(χ^(2)=3.147,P=0.369);夏(6月、7月、8月)秋(9月、10月、11月)季节的EV检出率分别为65.52%及70.83%,明显高于春季(3月、4月、5月)及冬季(12月、1月、2月)的33.33%及0.00%,且存在统计学差异(χ^(2)=22.504,P=0.000)。EV阳性和非EV阳性患儿发热、头痛、呕吐阳性率无显著差异(P>0.05)。EV阳性和非EV阳性患儿EEG、头部MRI检查异常发生率无显著差异(P>0.05)。结论2018年石家庄市及周边地区儿童病毒性脑炎及脑膜炎的主要病原体为EV,其在夏秋季检出率高。Objective To investigate the pathogenic characteristics of viral encephalitis or meningitis in children living in Shijiazhuang city and surrounding areas,and to study the relationship between pathogenic and clinical findings.Methods A total of 132 cerebrospinal fluid specimens were randomly collected from hospitalized children diagnosed with viral encephalitis or meningitis(January 2018 to December 2018)in the Department of Neurology of Hebei Children′s Hospital in Shijiazhuang city and surrounding areas.The nucleic acids of four viruses in cerebrospinal fluid were detected by real-time quantitative PCR.SPSS 21.0 software was used for statistical analysis.Results Among the 132 cases,78 were boys and 54 were girls,with a sex ratio of 1.44∶1.However,in the gender composition of children in each age group,there was no significant difference(χ^(2)=3.901,P=0.272).Of the 132 children,121 had signs of fever,109 had symptoms of headache,92 had symptoms of vomiting,17 had abnormal electroencephalogram(EEG),and 15 had abnormal head magnetic resonance imaging(MRI).132 cerebrospinal fluid specimens were tested for pathogenic pathogens,and 80 of them were successfully detected.There was 1 case of human herpesvirus type I(HHV-I),2 cases of varicella-zoster virus(VZV)and 77 cases of enterovirus(EV).The age group of 1~3 years′s EV detection rate was 66.67%,it is the highest,but overall,the EV detection rate,there was no significant difference among the four age groups(χ^(2)=3.147,P=0.369).The detection rate of EV in summer and autumn were 65.52%and 70.83%,respectively,which were significantly higher than those in spring and winter(33.33%and 0.00%),and there was a significant difference(χ^(2)=22.504,P=0.000).There was no significant difference in the positive rates of fever,headache and vomiting between EV-positive and non-EV-positive children(P>0.05).There was no significant difference in the incidence of abnormal EEG and abnormal head MRI between EV-positive and non-EV-positive children(P>0.05).Conclusions In 2018,EV w

关 键 词：病毒性脑炎及脑膜炎 病原学 肠道病毒 

分 类 号：R725.1[医药卫生—儿科]