成人流行性乙型脑炎患者四例临床特点分析

目的 总结成人流行性乙型脑炎的临床特点,以提高对本病的认识和诊断水平.方法 回顾性分析2007-2008年我院收治的4例成人流行性乙型脑炎患者,总结其临床表现、实验室检查及MRI特点.结果 4例患者均为散发病例,男性2例,女性2例,发病年龄34～68岁,均为夏秋季发病;1例以腹泻起病,3例以头痛、发热起病;4例均有高热、精神异常;2例出现呼吸衰竭.实验室检查4例均有脑脊液白细胞升高,血清及脑脊液乙型脑炎病毒抗体IgM阳性.仅1例MRI见异常信号.2例有后遗症.结论 成人流行性乙型脑炎患者病情一般较重,临床表现不典型,易出现呼吸衰竭,需引起重视.

Clinical characteristics of epidemic Japanese encephalitis in adults

Objective To study the clinical characteristics of epidemic Japanese encephalitis in 4 adult patients and to improve the level of diagnosis.Methods The clinical characteristics, laboratory results and MRI features of 4 adult patients with epidemic Japanese encephalitis hospitalized in our hospital between 2007 and 2008 was retrospectively reviewed and analyzed.Results All patients were sporadic.Two were female and others were male with the age from 34 to 68 years old and onset in summer and autumn.One patient had diarrhea at onset while others had fever and headache at onset.All patients had high fever and psychiatric symptoms.Two patients had respiratory failure.Obvious elevation of white cells in cerebrospinal fluid was seen in all patients and Japanese viral antibody of IgM was all positive whereas the image of MRI was abnormal only in one patient.Two patients had neurological sequelae.Conclusions The clinical manifestations of epidemic Japanese encephalitis in adults are severe and untypical and the respiratory failure is likely to occur.