病毒性脑炎患者肠道病毒RT-PCR检测的临床意义初探(英文)

RT-PCR essay for enterovirus of viral encephalitis patients

目的探讨对病毒性脑炎患者的脑脊液(CSF)进行肠道病毒(EV)逆转录-聚合酶链式反应(RT-PCR)检测的临床诊断和治疗意义。方法用1对针对EV多数血清型的特异性通用引物组建的逆转录-聚合酶链式反应对43例临床诊断为病毒性脑炎患者的CSF进行临床检测,同时观察这些患者的临床症状、体征、脑脊液生化常规及病毒其他病原体检查,头颅影像学和脑电图检查,用t检验进行统计学分析。结果CSF肠道病毒逆转录-聚合酶链式反应(EVRT-PCR)阳性者18人,占41.9%,临床症状、病情轻重与阴性者无明显差异,CSF蛋白和细胞数较高,可同时合并血中其他病毒(单纯疱疹病毒、巨细胞病毒)抗体阳性。结论EV引起的病毒性脑炎发病率高,并可合并其他病毒感染,EVRT-PCR与血清学检查结果存在不一致性,EVRT-PCR检查结果可指导临床诊断和针对性用药。

Objective To understand the effects ofmRNA assay for enterovirus in cerebrospinal fluid （CSF） of patients by using reverse transcription polymerase chain reaction （RT-PCR） on clinical diagnosis and therapy of viral encephalitis. Methods RT-PCR with one pair of picornaviridae-specific primer （PSP） against the conserved 5＇noncoding region of enterovirus （EV） was employed to investigate enterovirus RNA in CSF of 43 patients who were diagnosed as viral encephalitis by their clinical features. The patients＇ symptoms, abnormal signs and laboratory evaluation including routine examinations of CSF, CSF biochemistry, antibodies to other virus in CSF, cranial computed tomography （CT）, cranial magnetic resonance imaging （MRI） and electroencephalogram （EEG） were observed and statistically analyzed by Student＇ s tests. Results By the CSF EV RT-PCR, 18 out of 43 patients, most of them male, were tested to be EV positive （41.9%）, and their symptoms and signs were not significantly different from that of EV negative. The albumen and cell content in CSF of the patients of EV positive was higher than patients of negative. Sometimes antibodies to other virus could be found in serum of EV positive patients. Conclusion Viral encephalitis owing to enterovirus has higher morbidity and sometimes goes with other virus infection. The results of EV RT-PCR are not always consistent with that of serum assay. The result of EV RT-PCR could be used to guide clinical diagnosis and treatment.