病毒性脑炎患者脑脊液肠道病毒和EV71检测与分析

目的 探讨肠道病毒和EV71所致脑炎的发病情况及荧光定量PCR诊断病毒性脑炎的意义.方法 收集银川市118例临床诊断病毒性脑炎、脑膜炎患者脑脊液和血清,用荧光定量PCR检测肠道病毒和EV71阳性率及病毒拷贝数,用间接酶联免疫吸附试验（ELISA）定性检测血清EV71病毒IgM抗体.结果 荧光定量PCR检测肠道病毒阳性病例42例,检测阳性率为35.6％;EV71阳性病例22例,检测阳性率为18.6％,占EV阳性病例的52.3％;ELISA定性检测EV71病毒IgM抗体,阳性病例30例,检测阳性率25.4％,肠道病毒和EV71病毒性脑炎患者6岁以内幼儿明显多见于其他年龄组.结论 肠道病毒是本地区病毒性脑炎、脑膜炎患者最常见的病原体,EV71可能是本地区肠道病毒性脑炎中最多见的一种,肠道病毒和EV71感染所致脑炎都以6以内幼儿为主;荧光定量PCR对EV71检测特异性高于ELISA.

Analysis of enteroviruses and enterovirus 71 in cerebrospinal fluid in patients with viral encephalitis

Objective To investigate the incidence of viral encephalitis/meningitis caused by enteroviruses （EV） and EV71 and the value of FQ - PCR in diagnosis of encephalitis. Methods Cerebrospinal fluid and serum were collected from 118 patients with clinical diagnosis of viral encephalitis/meningitis in Yinchuan hospitals. The positive rate of enteroviruses was detected by FQ - PCR; the positive rate of EV71 was detected by FQ -PCR, and the IgM antibody against EV71 was examined by using enzyme -linked immunosor- bent assay （ELISA）. Results By using FQ - PCR for enteroviruses in CSF, 42 out of 118 patients were positive for enteroviruses （41.9%） ,and 22 out of 118 patients were positive for EV71 enterovirus （18.6%）. Among the patients positive for enteroviruses, 52.3% （22/42） patients were positive for EV71 ,while 30 out of 118 patients were positive for IgM antibody against EV71 （25.4%） when examined using ELISA. In addition,the viral encephalitis/meningitis patients caused by enteroviruses and EVT1 were more common in children less than 6 years old. Conclusion Enteroviruses are the main pathogens responsible for viral encephalitis/meningitis in Yin- chuan and EV71 may be most common pathogen among enteroviruses. Viral encephalitis/meningitis caused by enteroviruses and EV71 are mainly distributed in children less than 6 years old. Moreover, the specificity of FQ - PCR in detection of EV71 is higher than ELISA.