80例儿童病毒性脑炎病原学结果、脑电图表现及影像学特征

Etiological results,electroencephalogram manifestations,and imaging features of 80 children with viral encephalitis

目的分析儿童病毒性脑炎病原学结果、脑电图表现及影像学特征。方法选取2020年1月~2022年6月我院诊治的病毒性脑炎患儿80例,分析其病原学结果、脑电图表现及影像学特征。结果80例病毒性脑炎患儿中检出20例(25.00%)病毒学检测阳性,包括8例(10.00%)肠道病毒(enterovirus,EV)、3例(3.75%)人类疱疹病毒6型(human herpesvirus type 6,HHV6)、2例(2.50%)腺病毒(adenovirus,ADV)、2例(2.50%)巨细胞病毒(cytomegalovirus,CMV)、3例(3.75%)甲型流感病毒(influenza A virus,FluA)、2例(2.50%)单纯疱疹病毒(herpes simplex virus,HSV)。80例病毒性脑炎患儿中,脑电图检查异常者64例(80.00%),以δ慢波为主(23例,28.75%),尖波(10例,12.50%)、尖-棘波(2例,2.50%)、纺锤波(3例,3.75%)相对少见。80例病毒性脑炎患儿中,头颅磁共振成像(magnetic resonance imaging,MRI)检查11例(13.75%)异常,包括1例(2.5%)单侧局限病灶、2例(3.75%)双侧病灶、8例(15.00%)3个及以上部位病灶;累及基底核区9例(11.25%)、脑干3例(3.75%)、大脑1例(1.25%)。结论病毒性脑炎患儿采用实时荧光定量PCR技术检测病原学快速可行,EV为儿童病毒性脑炎的主要病原体;脑电图、头颅MRI检查在儿童病毒性脑炎诊断中具有重要价值,能够为临床提供一定指导。

Objective To analyze the etiological results,electroencephalogram(EEG)manifestations,and imaging features of 80 children with viral encephalitis.Methods Eighty children with viral encephalitis treated in our hospital from January 2020 to June 2022 were selected,and their pathogenic results,EEG manifestations,and imaging features were analyzed.Results Among 80 children with viral encephalitis,20 cases(25.00%)tested positive for virology,including 8 cases(10.00%)of enterovirus(EV),3 cases(3.75%)of human herpesvirus type 6(HHV6),2 cases(2.50%)of adenovirus(ADV),2 cases(2.50%)of cytomegalovirus(CMV),3 cases(3.75%)of influenza A virus(FluA),and 2 cases(2.50%)of herpes simplex virus(HSV).Among 80 children with viral encephalitis,64 cases(80.00%)had abnormal electroencephalogram examination.δslow waves were predominant(23 cases,28.75%),while sharp waves(10 cases,12.50%),sharp spikes(2 cases,2.50%),and spindle waves(3 cases,3.75%)were relatively rare.Among 80 children with viral encephalitis,11 cases(13.75%)showed abnormalities in head magnetic resonance imaging(MRI),including 1 case(2.5%)with unilateral localized lesions,2 cases(3.75%)with bilateral lesions,and 8 cases(15.00%)with 3 or more lesions;Nine cases(11.25%)affected the basal ganglia,three cases(3.75%)affected the brainstem,and one case(1.25%)affected the brain.Conclusion Real time fluorescence quantitative PCR technology is fast and feasible for detecting pathogens in children with viral encephalitis,and EV is the main pathogen of viral encephalitis in children;Electroencephalography and cranial MRI are of great value in the diagnosis of viral encephalitis in children,and can provide some guidance for clinical practice.