【摘要】：目的 持續(xù)觀察長(zhǎng)沙地區(qū)急性中樞神經(jīng)系統(tǒng)病毒感染性疾病的病原學(xué)構(gòu)成,為其防治提供參考依據(jù)。 方法 建立腸道病毒(EV)、麻疹病毒(MV)、腮腺炎病毒(MuV)、雙�？刹《�(HPeV)、乙型腦炎病毒(JEV)、單純皰疹病毒1型(HSV-1)、單純皰疹病毒2型(HSV-2)、腺病毒(ADV)、水痘帶狀皰疹病毒(VZV)、EB病毒(EBV)、人類皰疹病毒6型(HHV-6)等11種病毒實(shí)時(shí)熒光定量PCR (FQ-PCR)檢測(cè)方法。收集2011年10月至2013年7月湖南省人民醫(yī)院兒童醫(yī)學(xué)中心急性病毒性腦炎、腦膜炎及腦膜腦炎住院兒童CSF標(biāo)本,并使用FQ-PCR方法檢測(cè)EV、MV、MuV、HPeV、JEV、HSV-1、HSV-2、ADV、VZV、EBV、HHV-6等11種常見(jiàn)病毒。查閱相關(guān)病歷資料,結(jié)合檢測(cè)結(jié)果,對(duì)流行病學(xué)資料和臨床特征進(jìn)行分析。 結(jié)果 1.成功構(gòu)建EV、MV、MuV、HPeV、JEV、HSV-1、HSV-2、ADV、VZV、 EBV、HHV-6等11種病毒的標(biāo)準(zhǔn)品及標(biāo)準(zhǔn)曲線,建立了上述病毒FQ-PCR檢測(cè)方法。 2.本研究期間收集了急性病毒性腦炎、腦膜炎及腦膜腦炎住院兒重CSF標(biāo)本共161份,使用FQ-PCR方法檢出71例病毒,總檢出率44.10%(71/161)。EV檢出率最高,為18.01%(29/161),其次為MuV,檢出率8.07%(13/161),MV為7.45%(12/161), EBV、HPeV均為4.97%(8/161),ADV為3.73%(6/161),HHV-6為2.48%(4/161),JEV、HSV-1、HSV-2均為0.62%(1/161),未檢出VZV。 3.161例住院兒童中,臨床診斷為急性病毒性腦炎82例,急性病毒性腦膜炎20例,急性病毒性腦膜腦炎59例；男性93例,女性68例,男女比例為1.37：1；年齡最小為3個(gè)月,最大為13歲,平均月齡為52.51±38.35。入院在春季病例46例,夏季52例,秋季28例,冬季35例。城市兒童93例,農(nóng)村兒童68例。不同疾病、性別、年齡、季節(jié)及城鄉(xiāng)之間住院兒童CSF標(biāo)本中的病毒檢出率無(wú)統(tǒng)計(jì)學(xué)差異。 4.CSF標(biāo)本病毒檢出陽(yáng)性病例與陰性病例之間臨床癥狀與體征均無(wú)差異。病毒檢出陽(yáng)性與陰性病例之間輔助檢查結(jié)果無(wú)統(tǒng)計(jì)學(xué)差異。 5.本組資料中檢出的病毒平均載量為198.24±993.61copies/μL。檢出的病毒載量與住院時(shí)間無(wú)顯著相關(guān)。 6.EV檢出病例多見(jiàn)于急性病毒性腦膜腦炎；以春夏季節(jié)多見(jiàn)；在3-6歲年齡段檢出率最高。HHV-6檢出病例多見(jiàn)于秋季；ADV陽(yáng)性病例以農(nóng)村患兒多見(jiàn)。MuV檢出病例僅1例有腮腺腫大。12例檢出MV的病例均無(wú)麻疹典型表現(xiàn)。 結(jié)論 1.本研究期間內(nèi)從長(zhǎng)沙地區(qū)急性病毒性腦炎、腦膜炎及腦膜腦炎住院兒童CSF標(biāo)本中檢出10種常見(jiàn)病毒,檢出率較前期研究略有上升,MV和MuV檢出明顯增多； 2.病毒檢出陽(yáng)性與陰性病例在性別、年齡、季節(jié)、城鄉(xiāng)以及臨床特征之間無(wú)差異； 3.急性病毒性腦炎檢出病毒載量高于腦膜炎及腦膜腦炎的載量； 4.MuV、MV陽(yáng)性檢出病例各有其特點(diǎn)。
[Abstract]:Objective to observe the etiological composition of acute central nervous system virus infection in Changsha and provide reference for its prevention and treatment. Methods Enterovirus (EV), measles virus, (MV), mumps virus, (MuV), virus, (HPeV), encephalitis virus, (JEV), herpes simplex virus type 1 (HSV-1) were established. There are 11 real-time quantitative PCR (FQ-PCR) methods for detection of herpes simplex virus type 2 (HSV-2), adenovirus (ADV), varicella zoster virus (VZV), EB), (EBV), human herpesvirus 6 (HHV-6) and so on. CSF samples of hospitalized children with acute viral encephalitis, meningitis and meningoencephalitis were collected from Children's Medical Center of Hunan Provincial people's Hospital from October 2011 to July 2013. EV,MV,MuV,HPeV,JEV,HSV-1,HSV-2, was detected by FQ-PCR method. ADV,VZV,EBV,HHV-6 and other 11 common viruses. The epidemiological data and clinical features were analyzed by consulting relevant medical records and testing results. Result 1. The standard samples and standard curves of 11 viruses such as EV,MV,MuV,HPeV,JEV,HSV-1,HSV-2,ADV,VZV, EBV,HHV-6 were successfully constructed, and the detection method of FQ-PCR for these viruses was established. 2. During this study, 161 CSF specimens were collected from hospitalized children with acute viral encephalitis, meningitis and meningoencephalitis. 71 cases of virus were detected by FQ-PCR. The total detection rate was 44.10% (71 / 161). EV). The detection rate of MuV, was 8.07% (13 / 161), MV = 7.45% (12 / 161), EBV,HPeV was 4.97% (8 / 161), ADV = 3.73% (6 / 161). HHV-6 was 2.48% (4 / 161), JEV,HSV-1,HSV-2 was 0.62% (1 / 161), VZV. was not detected. Among the 3.161 hospitalized children, 82 cases were diagnosed as acute viral encephalitis, 20 cases as acute viral meningitis, 59 cases as acute viral meningoencephalitis. The average age was 52.51 鹵38.35. 46 cases were admitted in spring, 52 cases in summer, 28 cases in autumn and 35 cases in winter. There were 93 urban children and 68 rural children. There was no significant difference in the detection rate of CSF among different diseases, sex, age, season and urban and rural children. There was no difference in clinical symptoms and signs between positive and negative 4.CSF specimens. There was no statistical difference between positive and negative cases. 5. The average viral load was 198.24 鹵993.61copies/ 渭 L. There was no significant correlation between the viral load detected and the length of stay. 6.EV was more common in acute viral meningoencephalitis than in spring and summer, and was the highest in the age group of 3-6 years old. HHV-6 was more common in autumn. ADV positive cases were mostly found in rural children. Only 1 case with parotid gland enlargement was detected by MuV and 12 cases with MV had no typical manifestation of measles. Conclusion 1. Ten common viruses were detected in CSF samples of hospitalized children with acute viral encephalitis, meningitis and meningeal encephalitis in Changsha area during the study period. The detection rate was slightly higher than that in the previous study, and the detection rate of MV and MuV increased significantly; 2. There was no difference in sex, age, season, urban and rural areas and clinical features between positive and negative cases. The viral load of acute viral encephalitis was higher than that of meningitis and meningoencephalitis.
【學(xué)位授予單位】：湖南師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R725.1

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