经脑脊液宏基因组二代测序确诊的水痘-带状疱疹病毒脑膜脑炎临床分析  

Clinical analysis of varicella zoster virus meningoencephalitis diagnosed by metagenomic next-generation sequencing

作　　者：贾永林 张保华 朱丽娟 高营礼 高成恩 JIA Yonglin;ZHANG Baohua;ZHU Lijuan;GAO Yingli;GAO Cheng’en(Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院,河南开封475000

出　　处：《中国实用神经疾病杂志》2024年第5期622-626,共5页Chinese Journal of Practical Nervous Diseases

基　　金：开封市科技发展计划项目(编号:2203060)。

摘　　要：目的 探讨水痘-带状疱疹病毒(VZV)脑膜脑炎患者的诊断方法及脑脊液检查特点。方法回顾性分析开封市中心医院收治的15例应用脑脊液二代测序诊断的VZV脑膜脑炎的临床特点及实验室检查结果并行临床分析。结果 15例VZV脑膜脑炎患者中,11例表现为头痛,发热7例,合并皮肤带状疱疹8例,面神经麻痹1例,认知功能障碍4例,癫痫发作2例。脑脊液结果:白细胞数轻-中度升高,以淋巴细胞为主,其中6例氯化物降低,5例乳酸增高。结论 VZV脑膜脑炎患者临床上多表现为头痛,合并发热、皮肤带状疱疹者较多。脑脊液宏基因组二代测序是诊断VZV脑膜脑炎的一种新的有效方法。中枢神经系统VZV主要表现为脑膜炎与脑膜脑炎,抗病毒治疗预后良好。Objective To investigate the diagnostic methods and the characteristics of cerebrospinal fluid examination in patients with varicella zoster virus(VZV)meningoencephalitis.Methods The clinical characteristics and laboratory test results in 15 cases of VZV meningoencephalitis in the Kaifeng Central Hospital by testing cerebrospinal fluid examples with next-generation sequencing technology were analyzed.Results Eleven patients with VZV meningoencephalitis had headaches,7 had fever,8 had skin rash,1 had facial nerve palsy and 4 got cognitive dysfunction.Moderate lymphocytic pleocytosis were detected in 5 cerebrospinal fluid examples.Chloride decreased in 6 examples and lactic acid increased in 5 examples.Conclusion The headache,fever and skin herpes zoster generally are the clinical characteristics in patients with VZV meningoencephalitis.Metagenomic next-generation sequencing of cerebrospinal fluid is a new and effective method for diagnosing VZV meningoencephalitis.The mainly clinical presentations are meningitis and meningoencephalitis in patients with central nervous system(CNS)VZV infections.Patients with CNS VZV infections have a good prognosis for antiviral therapy.

关 键 词：二代测序 水痘-带状疱疹病毒 脑膜脑炎 脑脊液 

分 类 号：R512.3[医药卫生—内科学]