中枢神经系统感染性疾病的流行特征分析

目的 了解中枢神经系统感染性疾病的临床流行特征。方法 对2012—2016年间安徽医科大学第一附属医院住院诊断为中枢神经系统感染的805例病例进行回顾性资料分析。按照病种构成、年度分布、年龄分布、季节分布、性别差异、城乡分布和病死率等特征进行临床流行病学统计分析。结果 主要病种构成依次为:病毒性脑炎73.4%,化脓性脑膜炎13.2%、结核性脑膜炎8.0%、隐球菌脑膜炎4.2%、脑寄生虫病1.2%。病毒性脑炎发病年龄以10岁以内儿童感染为主,化脓性脑膜炎10岁以内和60岁以上年龄段感染者较多,结核性脑膜炎发病集中在10岁以后且有老龄化趋势,隐球菌脑膜炎以青壮年发病较多。病毒性脑炎和结核性脑膜炎的发病季节主要是春季。5种中枢神经系统感染性疾病中,男女构成比均差异无统计学意义(P>0.05)。除脑寄生虫病10例均发生于农村,其他四种城乡差异无统计学意义(P>0.05)。中枢神经系统感染性疾病的总病死率为8.8%,病死率前3位者为隐球菌脑膜炎、结核性脑膜炎、化脓性脑膜炎。化脓性脑膜炎病原菌以肺炎链球菌、大肠埃希菌、脑膜炎双球菌为主。引起病毒性脑炎的病毒主要为肠道病毒及疱疹病毒。结论 安徽地区中枢神经系统感染的病种构成依次为:病毒性脑炎＞化脓性脑膜炎＞结核性脑膜炎。儿童病毒性脑炎和化脓性脑膜炎多见,老年人化脓性脑膜炎和结核性脑膜炎多见,HIV合并隐球菌脑膜炎有所增加。中枢神经系统感染病死率较高。

Analysis of epidemiological features for inpatients with infectious diseases of the central nervous system

Objective To understand the clinical epidemiological characteristics of central nervous system infection.Methods Retrospective review of patients who were diagnosed as central nervous system infection in The First Affiliated Hospital of Anhui Medical University from 2012 to 2016 was performed.Statistical analysis of disease categories,year distribution,age distribution,seasonal distribution,gender differences,rural-urban distribution and mortality was done.Results Main disease categories are as below in order:viral encephalitis (meningitis) 73.4%;purulent meningitis 13.2%;tuberculous meningitis 8.0%;cryptococcal meningitis 4.2%;cerebral parasitic disease 1.2%.Viral encephalitis (meningitis) mainly affects children aged 10 or below;purulent meningitis mostly affects children aged 10 or below and people aged above 60;tuberculous meningitis cases are mostly people aged above 10 and show a trend of aging;cryptococcal meningitis mainly affects young adults.Attack of viral encephalitis (meningitis) and tuberculous meningitis is the most obvious in spring.The men and women constitute ratio differences of viral encephalitis (meningitis),tuberculous meningitis,purulent meningitis,cryptococcal meningitis,and cerebral parasitic disease are not obvious (P>0.05).Except for 10 cases of cerebral parasitic disease occur in rural areas,and the other four rural-urban differences are not statistically significant (P>0.05).Total mortality of central nervous system infection is 8.8%.The top 3 mortalities are cryptococcal meningitis,tuberculous meningitis and purulent meningitis.Main pathogens of purulent meningitis include streptococcus pneumonia,escherichia coli and diplococcus meningitidis.Viruses that can induce viral encephalitis (meningitis) are mainly herpes virus and enterovirus.Conclusion Main disease categories of central nervous system infection in Anhui area was as below in order:viral meningitis>purulent meningitis>tuberculous meningitis.Viral meningitis and purulent meningitis were more common in children.Purulent meningitis and tuberculosis meningitis were more common in the elderly,and cryptococcal meningitis has increased in AIDS patients.Central nervous system infection had high mortality rate.