无菌性脑炎与肠道病毒感染关系监测

目的：探讨无菌性脑炎发病与肠道病毒感染的关系。方法：对1994年苍山县和1996年栖霞市发生的两起无菌性暴发病例和1996年7月－1997年3月济南市两所医院无菌性脑炎住院病例进行流行病学和临床特征的调查，并采集部分病例粪便或脑脊液标本进行肠道病毒分离或／和PCR检测。结果：无菌性脑炎的高发季节为春夏季或夏秋季，主要发病年龄为 婴幼儿和小学生；临床以发热和神经系统症状为主，而少见腹泻与皮疹等前驱症状，多数病例的病程较短（10－19天）且预后较好，个别病例发生死亡。两起无菌性脑炎暴发病例的粪便标本病毒分离分别以CoxB3和CoxB5病毒为优势毒株，初步判定为CoxB病毒引致的病毒性脑炎；对住院的无菌性脑炎病例脑脊液标本进行PCR检测，其中8例CoxB病毒为阳性，且3例分离到CoxB3病毒，故这8例病例确诊为CoxB2病毒引致的病毒性脑炎。结论：CoxB病毒是导致我省局部地区病毒性脑炎流行的主要病原，今后应加强肠道病毒引起的病毒性脑炎的监测和防治研究工作。

Surveillance on Relationship Between Enteroviruses Infection and Epidemic of Non -bacterial Encephalitis

Objective To explore the relationship between the enteroviruses infection and the epidemic of aseptic.Methods The outbreak cases of aseptic encephalitis from Cangshan county in 1994 and Qixia city in 1996,and the cases of aseptic encephalitis admitted to the two hospitals of Jinan city from July of 1996 to March of 1997 were investigated on epidemiological and clinical characteristics.Some stool or cerebrospinal fluid (CSF) specimens from cases were collected and used for the enteroviruses isolation or/and polymease chain reaction (PCR) detection.Results The epidemic peak seasons of aseptic encephalitis were spring/summer or summer/autumn.Most cases were infants,young children and primary school children.The clinical symptoms of aseptic encephalitis were common with fever and central nervous systemic signs but few with diarrhea and rash.Most cases recovered within 10 to 19 days of disease course,but a few cases died.The two outbreak cases were primarily diagnosed as viral encephalitis caused by coxackievirus (Cox) group B infection because the dominant enterovirus isolates from stool specimens were CoxB 3 and CoxB 5,respectively.Eight cases from the two hospitals of Jinan city were positive to CoxB PCR detection,among them 3 CoxB 3 virus strains were isolated,and confirmed as viral encephalitis caused by CoxB virus infection.Conclusion The etiology of the virial encephalitis epidemics in some areas of Shandong province was mainly caused by CoxB viruses infection.The surveillance and studies on prevention of the enterovial encephalitis should be carried out in the future.