【摘要】 目的了解上海市疑似流行性乙型脑炎(乙脑)患者的病原谱构成。方法将2010年5-10月收集的145例疑似乙脑患者的93份血清、103份脑脊液标本采用实时荧光PCR(real-time PCR)法和酶联免疫吸附试验(ELIAS)检测常见脑炎病毒核酸和病毒IgM抗体。检测病毒包括乙脑病毒(JEV)、肠道病毒(EV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)、水痘-带状疱疹病毒(VZV)、麻疹病毒(MV)、呼吸道合胞病毒(RSV)、腮腺炎病毒(MuV)、西尼罗病毒(WNV)。结果 100例检出病毒核酸和/或病毒IgM抗体阳性(68.97%),病毒核酸或病毒IgM抗体检测阳性作为判断病毒感染的指标,其中EV感染49例(33.79%)、HSV感染22例(15.17%)、JEV感染11例(7.59%)、CMV感染5例(3.45%)、MuV感染3例(2.07%),另有10例病例判断为两种或以上病毒混合感染(6.90%),未检出VZV、MV、RSV、WNV。结论 2010年上海市疑似乙脑患者病原以EV、HSV和JEV为主,提示在乙脑流行季节,需加强病毒性脑炎的监测和鉴别诊断,为临床诊治和疾病防控提供科学依据。更多还原

【Abstract】 Objective To understand the pathogenic spectrum of suspected Japanese encephalitis cases in Shanghai.Methods A total of 93 serum samples and 103 cerebrospinal fluid samples were collected from 145 suspected Japanese encephalitis cases during May-October 2010 to detect viral nucleic acid and IgM antibodies of common encephalitis viruses by using real-time PCR and ELISA.The detected viruses included Japanese encephalitis virus(JEV),enteric virus(EV),cytomegalovirus(CMV),herpes simplex virus(HSV),varicellla-zoster virus(VZV).measles virus(MV),respiratory syncytial virus(RSV),mumps virus(MuV) and West Nile virus(WNV).Results A total of 100 samples were detected to be positive either in viral nucleic acid detection or in IgM antibody detection,the positive rate was 68.97%(100/145).Among these 100 patients,49(33.79%) were infected with EV,22(15.17%) were infected with HSV,11(7.59%) were infected with JEV,5(3.45%) were infected with CMV,3(2.07%) were infected with MuV,and 10(6.90%) were co-infected with two or more viruses;No VZV,MV,RSV and WNV were detected.Conclusion The major pathogens in suspected Japanese encephalitis cases were EV,HSV and JEV in Shanghai in 2010.The study results indicated that the surveillance and differential diagnosis of viral encephalitis should be strengthened even in the high incidence season of Japanese encephalitis to provide clinical information for diagnosis and treatment of the disease as well as scientific evidence for the disease control and prevention.更多还原