唐山地区儿童病毒性脑炎病原学研究

目的:了解唐山市地区儿童病毒性脑炎的病原学特征。方法:选择2009年1月～2012年12月在唐山市妇幼保健院进行治疗的166例病毒性脑炎疑似患儿为研究对象,入选病例急性期均做血常规检查,采用荧光PCR方法对脑脊液进行病毒检测,采用ELISA的方法检测血清病毒IgM抗体。结果:所有标本中,EV71病毒检出率最高,为20.5%,其次为CV病毒,检出率为12.7%,位居第三位是HSV病毒,检出率为9.6%。PCR和ELISA检测对EV71、CV和HSV检出率有统计学差异(P<0.05)。﹤3岁和≥3岁儿童病原体总检出率比较,差异有统计学意义(P<0.05)。PCR检测和ELISA检测对病原体总检出率比较,差异有统计学意义(P<0.05)。结论:唐山地区儿童病毒性脑炎的病原体仍以肠道病毒71型、柯萨奇病毒及单纯疱疹病毒为主;尤以3岁以下儿童易感,应加强此类儿童群体的防控;应联合应用PCR与ELISA检测,提高病原体的检出率。

Study on etiology of viral encephalitis in children in Tangshan city

Objective: To understand the etiological characteristics of viral encephalitis in children in Tangshan city.Methods: A total of 166 children suspected of viral encephalitis who were treated in the hospital from January 2009 to December 2012 were selected as study objects,blood routine test was conducted among the children at acute phase,fluorescent PCR was used to conduct viral test in cerebrospinal fluid,ELISA was used to detect serological IgM antibody.Results: Among the samples,the detection rate of enterovirus 71 was the highest,which was 20.5%,followed by coxsackievirus(12.7%) and herpes simplex virus(HSV)(9.6%).There were statistically significant differences in detection rates of enterovirus 71,coxsackievirus and HSV between PCR and ELISA(P < 0.05).There was statistically significant difference in the total detection rate of pathogens between children under three years and children aged three years old or more than three years(P < 0.05).There was statistically significant difference in the total detection rate of pathogens between PCR and ELISA(P < 0.05).Conclusion: The main pathogens of viral encephalitis in children in Tangshan city are enterovirus 71,coxsackievirus and HSV;the children under three years old are more susceptible,so the prevention and control should be strengthened among the children under three years old;joint detection of PCR and ELISA can improve the detection rate of pathogens.