肠道病毒脑炎的季节分布及临床特点

目的探讨肠道病毒所致病毒性脑炎（肠道病毒脑炎）在各个季节的分布及I}缶床特点。方法全部病毒性脑炎患者在疾病的急性期留取脑脊液，按比例在每季节各随机抽取15例、42例、14例和9例患儿，以PCR法检测肠道病毒，观察肠道病毒脑炎的流行病学特点及临床特征。结果①80例患儿中肠道病毒PCR阳性22例（27．5％），其中春季13．3％（2／15），夏季35．7％（15／42），秋季26．7％（4／14），冬季11．1％（1／9）。②肠道病毒感染者和非肠道病毒感染者脑脊液、头颅CT与脑电图的异常情况差异无统计学意义（P〉0．05）。③临床情况：两组发热、惊厥和意识方面比较，差异无统计学意义（P〉O．05）；皮肤肌肉刺痛、口角或咽峡疱疹、扁桃体灰白小点及心肌损害方面，两组比较差异有统计学意义（P〈0．01）；肝功能损害方面，两组比较差异有统计学意义（P〈0．05）。结论①肠道病毒脑炎和非肠道病毒所致病毒性脑炎在季节分布、脑脊液常规、脑脊液生化、头颅CT、脑电图及发热、惊厥、意识改变等方面无显著差异；②肠道病毒脑炎较易出现肌肉刺痛、咽峡黏膜疱疹及心、肝功能损害，患儿扁桃体上可见灰白斑点。

Research on the Seasonal Distribution and Clinical Features of Viral Encephalitis Caused by Enterovirus

Objective To discuss the seasonal distribution and clinical features of viral encephalitis caused by enterovirus infection. Methods Keep the cerebrospinal fluid （CSF） from all patients with viral encephalitis in the acute phase;in each season,randomly select 15,42,14 and 9 samples to conduct PCR test to check for enterovirus and observe the epidemiological and clinical features. Resuits （1）There are 22 patients（27.5%） out of 80 indicate PCR positive,among which there is 13.3%（2/15） in spring,35.7%（15/42） in summer,26.7%（4/14） in autumn and 11.1%（1/9） in winter. （2）There is no significant difference for the occurrence of abnormalities of the cerebrospinal fluid （CSF）,coronal CT and EEG between the patients infected by enterovirus and the patients not infected by enterovirus （P〉0.05）. （3）Clinical manifestation：there is no significant difference in aspects of fervescence,convulsion and consciousness （P〉0.05）;there are significant differences in aspects of skin or muscle stinging,herpes in the corner of the mouth or fauces,small grey spots in the tonsil and cardiac damage（P〈0.01 ）;regarding hepatic injury（P〈0.05）,there are significant differences. Conclusion （1）There are no significant differences between viral encephalitis caused by enterovirus and viral encephalitis not caused by entemvirus in aspects of seasonal distribution, general chemical manifestation of CSF, coronal CT, EEG, fervescence, convulsion and consciousness ; （2） It is more possible for patients with viral encephalitis caused by enterovirus to suffer from muscle stinging,herpes in the mucosa of fauces,cardiac or hepatic damage and having grey spots in the tonsil.