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目的了解急性脑炎/脑膜炎病例病毒感染病原谱构成及流行病学特征。方法在宜昌市选取4家城区和2家周边区县医院作为哨点医院,收集2006-2012年急性脑炎/脑膜炎病例血清和脑脊液标本,采用ELISA方法检测乙脑病毒(JEV)、柯萨奇病毒(COX)、埃可病毒(ECHO)、单纯性疱疹病毒Ⅰ/Ⅱ型(HSV)、腮腺炎病毒(MuV)的IgM抗体。结果 2006-2012年共检测病例2 085份,JEV感染率呈逐年缓慢波动下降趋势,而MuV感染率呈逐年上升趋势。7~8月为病毒感染高峰。血清和脑脊液中JEVIgM抗体阳性率为2.49%(53/2 085)。在698份患者血清标本中MuV、HSV、COX、ECHO的IgM抗体阳性率分别为20.63%,18.77%,10.17%,8.60%。结论 MuV、HSV、COX、ECHO是宜昌市6所哨点医院急性脑炎/脑膜炎病例病毒性感染的主要病原,应加强此类病例的监测,特别是实验室病原学检测。
Objective To understand the composition of pathogens and epidemiological characteristics of virus infection in acute encephalitis / meningitis cases. Methods Four urban districts and two peripheral county hospitals were selected as sentinel hospitals in Yichang City. Serum and cerebrospinal fluid (CSF) samples of acute encephalitis / meningitis cases were collected from 2006 to 2012. The levels of JEV, (COX), echovirus (ECHO), herpes simplex virus type I / II (HSV) and mumps virus (MuV). Results A total of 2 085 cases were detected in 2006-2012. The infection rate of JEV showed a slowly fluctuating trend year by year. However, the infection rate of MuV showed an increasing trend year by year. 7 to August for the peak of virus infection. The positive rate of JEVIgM antibody in serum and cerebrospinal fluid was 2.49% (53/2 085). The positive rates of IgM antibodies against MuV, HSV, COX and ECHO in 698 serum samples were 20.63%, 18.77%, 10.17% and 8.60%, respectively. Conclusions MuV, HSV, COX and ECHO are the main pathogens of viral infection in acute encephalitis / meningitis cases in 6 sentinel hospitals in Yichang. Monitoring of such cases should be strengthened, especially in laboratory etiology.