【摘要】 目的探讨单纯疱疹病毒性脑炎（ＨＳＶＥ）的诊断方法，了解对ＨＳＶＥ的治疗效果。方法应用聚合酶链反应（ＰＣＲ）技术和酶联免疫吸附测定（ＥＬＩＳＡ）方法，对２７例病毒性脑炎患儿的脑脊液进行单纯疱疹病毒（ＨＳＶ）ＤＮＡ和特异性ＩｇＭ抗体检测。结果ＨＳＶＤＮＡ阳性１１例；ＨＳＶＩｇＭ阳性４例，其中Ⅰ型３例，Ⅱ型１例；ＤＮＡ与ＩｇＭ同时阳性３例。将脑脊液检查ＨＳＶＤＮＡ阳性或ＨＳＶＩｇＭ抗体阳性者１２例诊断为ＨＳＶＥ，占４４％。对ＨＳＶＥ患儿予以静脉滴注无环鸟苷，连续用药一周，结果治愈８例，好转２例，自动出院及死亡各１例。结论ＰＣＲ与ＩｇＭ抗体检测两种方法相结合有助于ＨＳＶＥ病原学早期诊断，并指导ＨＳＶＥ的临床治疗更多还原

【Abstract】 Objective To study the diagnosis, clinical characteristics and prognosis of children with herpes simplex virus (HSV) encephalitis (HSVE). Methods HSV specific DNA and anti HSV IgM in the cerebrospinal fluid (CSF) were determined by polymerase chain reaction (PCR) and enzyme linked immunosorbent assay (ELISA) in 27 children with sporadic viral encephalitis. Results It was found that HSV DNA was positive in CSF specimens from 11 cases, and HSV IgM was positive in CSF specimens of 4 cases, including HSV type Ⅰ in 3 and type Ⅱ in 1; both HSV DNA and IgM were positive in specimens of 3 cases. Specimens from 8 cases were positive for HVS DNA but negative for HSV IgM. Only one specimen was positive for HSV IgM but negative for HSV DNA. The positivity for either HSV DNA or HSV IgM in the CSF specimens was considered to be HSVE. HSVE was diagnosed in 12 (44.4%) of the 27 children. All patients with HSVE received intravenous acyclovir therapy for 7 days as soon as the diagnosis was confirmed. Eight patients recorved completely, two had significant improvementm, one was discharged from the hospital with no improvement and one died. Conclusions The present study suggested that the conbination of specific DNA with IgM antibody determination should be used to obtain more accurate diagnosis of HSVE and the early identification of pathogen will be helpful to guide the treatment and improve the prognosis of HSVE.更多还原