甘肃省180例脑炎脑膜炎症候群病例脑脊液病原检测结果分析

The laboratory diagnosis of 180 cases with the syndromes of encephalitis and meningitis in Gansu province

目的:了解甘肃省脑炎脑膜炎症候群的病原种类及其分布特征。方法:对2009年6月-2011年3月甘肃省4市、州哨点医院送检的180例临床诊断为脑炎脑膜炎症候群患者的急性期脑脊液标本,用ELISA方法检测乙脑病毒IgM抗体,用多重PCR法检测乙脑病毒等7种病毒、脑膜炎奈瑟菌等5种细菌。结果:180例患者中的30例(16.67%)检测出相关病原,其中乙脑病毒IgM抗体阳性13例(7.22%),PCR检测,水痘-带状疱疹病毒7例(3.89%)人肠道病毒3例(1.67%)、EB病毒3例(1.67%)、C群脑膜炎奈瑟菌1例(0.56%)、巨细胞病毒1例(0.56%)、肺炎链球菌2例(1.12%),未检出人类疱疹病毒6型、单纯疱疹病毒1-2型、流感嗜血杆菌B型、B族链球菌、单增李斯特菌。结论:乙脑病毒是夏秋季甘肃省引起脑炎脑膜炎症候群的主要病原体,水痘-带状疱疹病毒次之,肠道病毒、EB病毒、肺炎链球菌、脑膜炎奈瑟菌也是重要的病原。

Objective：To use different diagnosis methods to study the pathogens and distributions of encephalitis and meningitis in Gansu province.Methods： 180 cerebrospinal fluid samples of the patients with the syndromes of encephalitis and meningitis were collected from four regions of Gansu province.Enzyme-linked immunosorbent assays（ELISA） was used to detect the IgM of Japanese encephalitis virus（JEV）.Polymerase Chain Reaction（PCR） were used to detect the specific genes of JEV,Varicella-Zoster virus（VZV）,Human enterovirus,Epstein-Barr virus（EBV）,Cytoegalovirus（CMV）,Human herpes virus 6（HHV6）,Herpes simplex virus 1/2（HSV 1/2） and five bacteria（S.pneumoniae,H.influenzaetype b,N.meningitidis,Group B Streptococcus,L.monocytogenes）.Results： 30 cases of 180 were positive（16.67%）.IgM of JEV is 13 cases（7.22%）.VZV is 7 cases（3.89%）,Human enterovirus is 3 cases（1.67%）,EBV is 3 cases（1.67%）,CMV is 1 case（0.56%）,S.pneumoniae is 2 cases（1.12%）,N.meningitidis is 1 case（0.56%）.Other pathogens were not found out.Conclusion： JEV was the main pathogen of encephalitis in Gansu,followed by VZV,Human enterovirus,EBV,S.pneumoniae and N.meningitidis.