脑脊液肠道病毒RT-PCR检测对病毒性脑炎患者的临床意义

Clinical Significance of RT-PCR Assay for Enterovirus in Patients with Viral Encephalitis

的了解脑脊液肠道病毒（EV）逆转录-聚合酶链式反应（RT—PCR）检测对病毒性脑炎患者的临床诊断和治疗意义。方法回顾分析2000～2003年进行了脑脊液EVRT—PCR检测的43例患者的临床特征，包括临床症状、体征、脑脊液生化常规及其他病毒病原体检查、头颅影像学和脑电图检查，并进行统计学分析。结果脑脊液EVRT—PCR阳性者18例，占41．9％，男性较多，多发病于7～9月。脑脊液EVRT-PCR阳性者的临床症状与阴性者无明显差异，但脑脊液蛋白和细胞数较高，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。结论肠道病毒引起的病毒性脑炎发病率高，并可合并其他病毒感染，EVRT-PCR检查结果可指导临床诊断和针对性用药。

Objective To understand the effects of mRNA 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 The clinical data of 43 patients with viral encephalitis who had been detected for enterovirus by RT-PCR in CSF from year 2000 to 2003 were retrospectively analyzed. The symptoms and abnormal signs and laboratory evaluation including CSF conventionality, CSF biochemistry, antibody for other virus in CSF, cranial computed tomography, cranial magnetic resonance imaging and electroencephalogram were observed and statistically analyzed. Results By using RT-PCR for enterovirus in CSF, 18 out of 43 patients were positive for enterovirus （41.90.%）, most of them were male, and their symptoms and signs had no obvious difference in comparison with those negative for enterovirus. The albumen and cell counts in CSF of the patients positive for entero- virus were more than those negative for enterovirus. Simultaneously antibodies against other viruses could be found in serum of enterovirus positive patients. Conclusion Viral encephalitis owing to enterovirus has a high morbidity and sometimes goes with other virus infection. The results of EV RT-PCR do not always consistent with those of serum assay. The result of enterovirus RT-PCR could be used to guide clinical diagnosis and treatment.