72例病毒性脑炎、脑膜炎病例调查

Investigation and Analysis of 72 Viral Encephalitis and Meningitis Cases

[目的]为掌握上海市病毒性脑炎和脑膜炎的发病、分布状况、诊断现况和病原谱情况,制定科学的防治策略。[方法]采用病史检索方式,对2006年1月到2008年6月上海市公共卫生临床中心收治入院的72例病毒性脑炎、脑膜炎的病例进行回顾性调查。[结果]72例病毒性脑炎分布于四个季节,发病以春夏季多见64例(占88.89%);男性55例(占76.39%),女性17例(占23.61%),男女比例为1∶0.31;本市20例(占27.78%),外地18例(占25.00%),输入性病例33例(占45.83%),1例为弃婴。72例病例临床诊断63.89%,病原学检测率36.11%。转归情况为全愈的42例,占58.33%;好转、无明显后遗症的21例,占29.17%;好转、但有后遗症(智力障碍、运动障碍)的4例(3例为乙脑病毒阳性,1例限于条件未作检测),占5.56%;死亡5例,占6.94%。72例病例中37例病例按国家预防免疫接种程序接种,所占比例为51.39%。[结论]加强病毒性脑炎病原学检测,建立快速、简便、特异的病原学诊断方法势在必行。

[Objective]To understand the prevalence,distribution,diagnostic status and pathogenic spectrum of viral encephalitis and meningitis in Shanghai,and work out scientific prevention and treatment strategies.[Methods]A retrospective survey was conducted for 72 viral encephalitis and meningitis inpatients treated in Shanghai Public Health Service Clinical Center during January 2006 to June 2008 with history retrieval.[Results]72 viral encephalitis cases were reported in 4 seasons,especially in spring and summer（64）,accounting for 88.89%.55 of them were male,accounting for 76.39% and 17 were female,accounting for 23.61% with the ratio of 1∶0.31.There were 20 local cases,accounting for 27.78%,18 non-local cases,accounting for 25.00%,33 imported cases,accounting for 45.83%,and 1 case was abandoned baby.Clinical diagnosis cases accounted for 63.89%,the rate of pathogenic detection was 36.11%,recovery cases accounted for 58.33%,the condition was better and no sequela in 21 case,accounting for 29.17%,the condition was better but with sequela（4 cases,mental retardation,motor disturbance）（3 of them were positive for encephalitis B virus,1 was not detected）,accounting for 5.56%.5 cases died,accounting for 6.94%,37 of the cases had been immunized according to the national immunization program,accounting for 51.39%.[Conclusion]It was imperative to strengthen pathogenic detection of viral encephalitis and establish a rapid,simple and specific etiological examination method.