柯萨奇病毒B引起无菌性脑膜脑炎流行的探讨

１９９６年～１９９８年每年度６月～９月在山东省烟台、威海地区交界处以乳山市为中心区域连续发生无菌性脑膜脑炎的暴发流行 ,我们对此次流行的流行病学、病原学及临床学进行综合分析 ,证实为由柯萨奇病毒Ｂ(ＣｏｘＢ)引起的病毒性脑膜脑炎 ,现分析如下。对象与方法一、对象１１２例患儿为本市在流行期间发病住本院的无菌性脑膜脑炎患儿 ,血清学检测抗体均阳性。二、方法对收集的各项流行病学资料、临床表现、转归进行综合分析。病原学研究主要采用血清学及对粪便、脑脊液病毒分离的方法 ,血清学检查包括急性期ＣｏｘＢ抗体ＩｇＭ测定、双…     

柯萨奇病毒B组脑膜脑炎1262例临床分析

目的 探讨柯萨奇病毒B组(CVB)脑膜脑炎的流行特征、临床特点和病原学诊断。方法 对1262例CVB脑膜脑炎患儿进行流行病学调查，各年龄组临床特征分析，同时进行血、脑脊液CVB特异性抗体检测，病毒分离。结果 农村患儿发病占84．9％，城市发病占15.1％；婴幼儿及学龄前儿童发病明显高于7岁以上组；除均发热外，缺乏神经系统典型表现，惊厥占l.6％，脑膜刺激征阳性占16％，锥体束征阳性13.6％，无定位体征。伴消化道症状26％，呼吸道症状4．1％。10例转氨酶增高，44例心肌酶谱增高。72例心电图异常，10例并重症心肌炎，6例死亡。血清CVB-IgM阳性率71．9％，脑脊液CVB-IgM阳性率31％，部分病毒分离为CVB5。结论 CVB可引起儿童脑膜脑炎流行，症状不典型，表现多样，轻重悬殊，治愈率高，并重症心肌炎抢救成功率低。血、脑脊液CVB特异性抗体检测有利于早期病原学诊断。     

柯萨奇病毒脑炎并心肌炎11例

1999年 4月～ 6月我科共收治因柯萨奇病毒所致的脑炎患儿 12 0例 ,其中合并心肌炎 11例 ,现报告如下。临床资料一、一般资料　男 8例 ,女 3例 ,～ 1ａ 5例 ,～ 3ａ 6例 ,病原学诊断均由北京儿研所和第四军医大学基因研究所鉴定为柯萨奇病毒。二、临床表现　 11例均有发热 ,体温 37.5℃～ 38℃ 3例 ,39℃以上 8例 ,嗜唾 11例 ,惊厥 7例 ,呕吐 4例 ,脑膜刺激征 5例 ,球麻痹 5例 ,偏瘫 1例 ,心律失常 5例 ,左心衰竭 3例 ,全心衰竭 8例 ,11例均表现为心源性休克。三、实验室检查　脑脊液蛋白均在 0 .5～ 0 .7ｇ/Ｌ ,白细胞 >10～ 10 0个 /ＨＰ ,…     

小儿柯萨奇B病毒循环抗原的临床监测

柯萨奇病毒于1958年在美国柯萨奇地区分离出而得名,属小RNA病毒,分A和B两组,其中B组病毒(简称CVB)在人类病毒性心肌炎、扩张性心肌病等疾病中占重要地位。为了进一步认识人CVB感染的特征,我们开展了CVB循环抗原(简称CVB-Ag)的检测,对临床防治CVB性心肌炎、心肌病有实际意义。 资料与方法 一、临床资料 随机观察1995年6月至1996年8月住院患儿148例,分成3组:A组(呼吸道感     

柯萨奇B病毒单克隆抗体制备及其临床应用价值探讨

柯萨奇B组病毒 (CoxsackievirusB,CVB)是病毒性心肌炎最常见和最重要的病原。诊断CVB感染的方法包括从组织或体液中分离病毒及通过血清学方法检测特异性病毒抗体,目前 ,临床上仍以此作为早期病原学诊断依据。为寻求快速、可靠的诊断方法 ,我们融合出CVB单克隆抗体 (CVB_McAb) ,并由此CVB_McAb建立了斑点免疫结合试验(DIBA) ,并与病毒分离法及酶联免疫吸附试验(ELISA)检测特异性IgM作比较 ,探讨CVB_McAb对柯萨奇B病毒性心肌炎临床辅助诊断的价值。材料与方法一、材料(一 )毒株 :柯萨奇B1～6 病毒毒株由上海市卫生防疫站提供…     

小儿柯萨奇B组病毒肺炎65例临床分析

柯萨奇B组病毒(CVB)感染是临床常见研究课题。随着研究的深入,发现CVB肺炎也较常见。但有关CVB肺炎特点的报道尚少,我们对1995年7月～1998年10月158例肺炎进行相关病原学检查,重点分析CVB肺炎的临床特点,现报道如下。     

病毒性心肌炎柯萨奇B组病毒中和抗体的检测

探讨抗柯萨奇B病毒（CVB）中和抗体在正常小儿的水平和诊断病毒性心肌炎中的作用。方法采用微量中和试验方法测定病毒性心肌炎患儿和正常小儿血清中抗CVB中和抗体水平,同时用ELISA方法测定心肌炎患儿CVB特异性IgM。结果正常小儿中和抗体检出率为77．27％（51／66）,心肌炎组为95．28％（101／106）;心肌炎组中和抗体异常率73．58％（78／106）,中和抗体异常儿中CVB－IgM阳性率为28．38％（21／74）。两组CVB型别分布均以B3感染为最多。结论病毒性心肌炎中以CVB3感染最为多见,因正常小儿CVB感染率很高,只有通过双份血清抗体效价4倍上升或下降才能证明近期存在感染。     

柯萨奇病毒性脑炎脑脊液70例分析

目前认为柯萨奇病毒 (ＣＶＢ)感染是引起病毒性脑炎 (病脑 )的主要病原之一。本研究检测了 70例初诊为ＣＶＢ感染患儿的脑脊液 (ＣＳＦ) ,同时对其血清行柯萨奇Ｂ病毒抗体(ＣＶＢ ＩｇＭ )检测 ,现报告如下。材料与方法一、临床资料　 1.2 0 0 0年 6月～ 2 0 0 1年 10月我院儿科住院病人 70例 ,年龄 3个月～ 13岁 ,男 36例 ,女 34例 ,来自城镇 46例 ,农村 2 4例。 2 .47例体温 >38℃ ,其中 31例>39℃ ,热程 4～ 6ｄ ,平均 5 .8ｄ ,表现头痛、呕吐、抽搐、意识改变等 ,脑膜刺激征和锥体刺激征 34例。 2 3例表现为腹痛、腹泻、恶心、呕吐等 ,…     

柯萨奇B3病毒致小鼠慢性心肌炎的初步研究

目的 探讨在建立慢性病毒性心肌炎及扩张型心肌病动物模型（ＤＭＣ）的实验途径,获得制造该模型所需的必要实验数据。方法 对柯萨奇Ｂ３亲心肌株病毒（ＣＶＢ３ｍ）进行驯化,感染不同品系的纯系实验小鼠,观察并记录感染小鼠的死亡及发病情况。结果 实验组昆明鼠和ＮＩＨ小鼠的死亡率分别为２．５％和７．５％,二者的心肌未见有明显的病理改变,Ｂａｌｂ／ｃ雄鼠感染ＣＶＢ３ｍ后死亡率为５１．７％,且发病较重,Ｂａｌｂ／ｃ     

丙种球蛋白对感染柯萨奇B3病毒小鼠心肌的保护及心肌炎的治疗作用

病毒性心肌炎发病过程免疫反应起了重要作用，近年国外在动物实验及临床上将人血静脉丙种球蛋白（ＩＶＩＧ）用于该疾病的防治，取得了较好的效果［１，２］。我们探讨了不同剂量的国产ＩＶＩＧ对小鼠感染柯萨奇Ｂ３病毒（ＣＶＢ３）后心肌的保护作用及治疗效果。材料及方...     

Using epidemiologic methods to test hypotheses regarding causal influences on child and adolescent mental disorders

Epidemiology uses strong sampling methods and study designs to test refutable hypotheses regarding the causes of important health, mental health, and social outcomes. Epidemiologic methods are increasingly being used to move developmental psychopathology from studies that catalogue correlates of child and adolescent mental health to designs that can test rival hypotheses regarding causal genetic and environmental influences. A two-part strategy is proposed for the next phase of epidemiologic research. First, to facilitate the most informed tests of causal hypotheses, it is necessary to develop and test models of the structure of hypothesized genetic and environmental influences on mental health phenotypes. This will involve testing the related hypotheses that there are both (a) dimensions of psychopathology that are distinct in the sense of having at least some unique genetic and/or environmental influences, and (b) higher-order domains of correlated dimensions that are all apparently influenced in part by the same genetic and/or environmental factors. The resulting causal taxonomy would organize tests of causal hypotheses regarding both factors that may broadly increase risk for multiple dimensions of psychopathology and factors that may specifically increase risk for each individual dimension. Second, it is necessary to make greater use of a number of powerful epidemiologic designs that allow rigorous tests of rival hypotheses regarding genetic and environmental causes.     

住院患儿肺炎支原体感染的血清学研究

目的了解我院儿科住院患儿肺炎支原体感染的流行病学特点及肺部和肺外感染与损害的分布情况。方法微量颗粒凝集法检测3 773例儿童肺炎支原体抗体,与632例成人进行对照,结合临床资料,进行统计学分析。结果儿童与成人肺炎支原体抗体阳性率分别为31.8%和25.2%,两者比较差异显著。5~14岁为高发年龄组。78.1%的儿童肺炎支原体感染为呼吸系统感染,36.8%有肺外感染和损害。结论肺炎支原体感染主要发生在年长儿。除肺炎外,对肺外感染和损害应引起重视,及时进行检测确诊。     

Epidemiology of invasive early-onset neonatal infection in a French administrative district: A 10-year population-based study

BackgroundIn light of the pending update of the French guidelines for the management of neonatal infections, knowing the current epidemiology of early-onset neonatal infection (EONI) is essential.ObjectivesThe aim of this study was to assess the current epidemiology of a French administrative district population of proven EONI, including umbilical cord blood procalcitonin levels.MethodsWe conducted a retrospective population-based study in the Nantes metropolitan area. We included all infants treated for proven EONI in the maternity, neonatology, and intensive care wards between 1 January 2006 and 31 December 2015 in the Nantes University Hospital.ResultsAmong the 140,502 children born during the study period, 61 cases of EONI were documented. The overall incidence of confirmed EONI was 0.43/1000 live births, with 0.23/1000 GBS (group B streptococcus) infections and 0.08/1000 Escherichia coli infections. The majority of infected newborns were full-term or late-preterm infants (67% were ≥ 34 weeks of gestation), 88% had symptoms of EONI in the first 24 h of life, most of which were respiratory. The mortality rate was 8% (in premature infants). Available in 51% of the population, the cord blood PCT value could contribute to an earlier diagnostic screening in 10% of cases but with a very low sensitivity.ConclusionsThe incidence of confirmed EONI is low in this French district. The diagnostic value of PCT umbilical blood cord should be assessed based on further studies before confirming its value. We suggest that a national registry of these rare but serious cases of EONI could contribute to monitoring the epidemiological progression as well as to optimizing our diagnostic and therapeutic strategies.     

Dual infection with influenza A and B viruses

A throat swab from a 7-year-old child with a mild influenza-like illness was cultured for respiratory viruses by standard and rapid plate culture methods. Standard culture yielded influenza B, whereas influenza A was obtained from rapid plate culture. Testing of the original sample by PCR confirmed the presence of both viruses. A surveillance program (Viral Watch) for respiratory viruses showed cocirculation of both these viruses in the community during this period.     

新生儿呼吸道病毒感染的研究进展

新生儿呼吸道病毒常见的病原体包括呼吸道合胞病毒、流感病毒、副流感病毒、腺病毒和鼻病毒等,其中呼吸道合胞病毒的感染最为常见。呼吸道病毒感染的新生儿不仅可以表现为咳嗽、鼻塞、流涕等呼吸道症状,严重者可导致多脏器损伤,是新生儿死亡的原因之一。以往受到更多关注的是新生儿期细菌感染所造成的危害,随着"旧病毒"的不断变异和新病毒的...     

Family infection in enterobiasis

In this collaborative study four clinicians, one each from Jaipur, Imphal, Madras and Varanasi, surveyed a total of 100 consecutive families of patients with enterobiasis. Perianal cellophane patch smears were taken on 4 consecutive mornings for diagnosis using a special Japanese device. All members of the patients’s family were persuaded to take the test. If one or more of other members were infected, the family was labelled an “infected family”. From this, Family Infection Raie (FIR) was calculated as :(number of infected familiesl total number of families) xl00. In addition Family Infection Extent (FIE) was calculated as :(number of infected members/total number of members) x 100. FIR was 80% and FIE ranged from 50 to 75%. These findings indicate that in 80% of the families of patients with enterobiasis one or more of other members are infected.     

柯萨奇B组病毒感染对肌酸激酶同工酶影响的研究

目的　动态观察磷酸肌酸激酶同工酶 (CK MB)的变化 ,分析柯萨奇B组病毒 (CVB)感染对CK MB的影响。方法　对上呼吸道感染 (A组 ) 132例、病毒性心肌炎 (B组 ) 80例 ,测定CK MB采用电泳法 ,CVB测定采用ELISA间接法。结果　①入院时上呼吸道感染和病毒性心肌炎患儿CK MB均异常 ,分别是 (35 6 8± 11 33)IU/L、(32 44± 10 0 5 )IU/L ;上呼吸道感染患儿的CK MB恢复较病毒性心肌炎患儿快 (P <0 0 1)。②CVB阳性患儿CK MB异常率高于CVB阴性组 (P <0 0 1)。③CVB感染在病毒性心肌炎患儿CK MB异常持续时间较呼吸道感染患儿长 (P <0 0 1)。结论　①呼吸道感染时CK MB异常率高 ,但恢复较快。②CVB感染对CK MB影响明显。③CK MB动态观察对病毒心肌炎防治有价值