【摘要】 目的了解济南市急性脑膜炎/脑炎综合征(acute meningit is/encephalitis syndrome,AMES)监测病例中流行性乙型脑炎病毒(japanese encephalitis virus,JEV)感染情况,探索其流行特征、发病情况,为科学防控乙脑疫情和制定防制策略提供依据。方法选取济南市辖区内省、市、县级医院各2所作为哨点监测医院,收集2008-2011年AMES病例血清和脑脊液样本,采用酶联免疫吸附试验检测流行性乙型脑炎病毒IgM抗体。将检测结果等数据录入AMES项目数据库(Epi Data),并应用Epi Info进行统计学分析。结果 2008-2011年共检测AMES监测病例1 829例,其中86.77%(1 587/1 829)和70.53%(1 290/1 829)的病例分别采集了血清和脑脊液样本,检出乙型脑炎病毒IgM抗体阳性病例229例,总阳性率为12.52%;血清和脑脊液样本抗体阳性检出率分别为10.78%(171/1 587)和8.92%(115/1 290);经统计学分析,地区间血清阳性检出率差异有统计学意义(χ2=9.99,P<0.01)。男性病例多于女性,男性病例1 179例,占64.46%,女性病例650例,占35.54%,男女性别比为1.81∶1;全年均有发病,但以7～10月为发病高峰;从年龄组看,70.42%(1 288/1 829)的病例数为<15岁年龄组,其检出阳性数占总阳性数的62.45%(143/229)。血清检测<15岁年龄组与15岁以上年龄组比较差异有统计学意义(χ2=6.18,P<0.05);各年龄组两两比较差异有统计学意义(χ2=14.58,P<0.05)。结论济南市乙脑IgM抗体阳性病例占AMES监测病例的12.52%,是引起AMES病例的主要病原体,应加强实验室鉴别检测,使乙脑与AMES中其他病种区分开来,为疾病预防和临床诊治提供重要依据,以减轻社会和病人家庭的疾病负担。更多还原

【Abstract】 Objective To understand the status of Japanese Encephalitis virus(JEV)infection among monitored patients with acute meningitis/encephalitis syndrome(AMES)in Jinan,and to provide practical basis for disease prevention.Methods Patients with AMES in 2 surveillance sentinel hospitals selected from each provincial,municipal and county hospitals were enrolled into the study from 2008 to 2011.Blood and CSF samples were collected for the detection of IgM antibody against JEV using ELISA.The test results were entered into AMES Project database(Epi Data),and were analyzed statistically by Epi Info software.Results A total of 1829 patients with AMES were enrolled from which 86.77%(1587/1829)blood samples and 70.53%(1290/1829)CSF samples were collected.229 patients were found to be anti-JEV IgM positive with the overall positive rate of 12.52%(229/1829).The positive rates of IgM in blood and CSF samples were 10.78%(171/1587)and 8.92%(115/1290),respectively.The seropositive rates were statistically different among patients from different regions(χ2=9.99,P<0.01).The number of male cases was almost double that of female ones with the gender ratio of 1.81∶1.July to October was the peak season although patients could appear at any time of the year.Majority of patients(70.42%)were under 15 years old,accounting for 62.45% of total positive cases.There was a significant difference of seropositive rate between age group of under 15 and over 15 years old(χ2=6.18,P<0.05)and a significant difference was also noticed by pairwise comparison of each age group(χ2=14.58,P<0.05).Conclusions 12.52% of the AMES cases are positive for anti-JEV IgM,indicating that JEV is the major pathogen for AMES.Therefore,laboratory etiologic detection is very important to distinguish JEV infection from AMES and to provide critical evidence for clinical diagnosis and treatment.更多还原