我国部分地区病毒性脑炎标本的实验室检测

目的 初步了解我国病毒性脑炎的病原种类及其分布特征.方法用ELISA方法对2004年至2006年从我国6个省份收集的771例临床诊断为病毒性脑炎患者的急性期血清和脑脊液标本检测乙脑病毒IgM抗体,然后对乙脑IgM抗体阴性的所有血清标本检测其他7种常见病毒IgM抗体.此外,用PCR方法对54例脑脊液标本检测肠道病毒、版纳病毒和辽宁病毒的基因.结果经血清学检测,771例患者中的567例(73.5%)检测出病毒特异性IgM抗体,构成顺序为乙脑病毒(47.0%)、腮腺炎病毒(10.6%)、肠道病毒(8.8%)、单纯疱疹病毒(5.7%)、麻疹病毒(0.4%)、水痘-带状疱疹病毒(0.4%)、EB病毒(0.4%)、巨细胞病毒(0.3%);经分子生物学检测,在54例脑脊液中检测到8例(14.8%)肠道病毒基因阳性标本,未检测到版纳病毒与辽宁病毒基因阳性标本.结论乙脑病毒是我国病毒性脑炎的首要病原,腮腺炎病毒次之,肠道病毒和单纯疱疹病毒也是重要的病原.

Laboratory testing of sepcimens from patients with viral encephalitis from some regions of China

OBJECTIVE: To understand the viral etiology of viral encephalitis in China by detecting IgM antibody and viral RNA in the clinical samples of patients from some provinces of China by enzyme-linked immunosorbent assay and polymerase chain reaction. METHOD: Serum and cerebrospinal fluid samples of 771 patients with viral encephalitis or meningitis were collected from six provinces of China and were stored at -20 degrees C or -70 degrees C. Enzyme-linked immunosorbent assays were used for detection of IgM antibody to Japanese encephalitis virus, coxsackievirus, echovirus, herpes simplex virus, measles virus, varicella-zoster virus, mumps virus, cytomegalovirus and Epstein-Barr virus. Polymerase chain reaction was applied for the detection of viral RNA of enteroviruses and seadornavirus. RESULTS: IgM antibody was detected in 567 of 771 (73.5%) cases. The most common pathogen was Japanese encephalitis virus (47.0%, 362/771), followed by mumps virus (10.6%, 82/771), enteroviruses (8.8%, 68/771), herpes simplex virus (5.7%, 44/771), measles virus (0.4%, 3/771), varicella-zoster virus (0.4%, 3/771), Epstein-Barr virus (0.4%, 3/771), and cytomegalovirus (0.3%, 2/771). Enterovirus was positive in 8 cases, seadornavirus was negative in all the cases by PCR. CONCLUSION: According to the study, Japanese encephalitis was the most important encephalitis in China. Mumps virus was another important pathogen. Enteroviruses and herpes simplex virus were also important pathogens.