无菌性脑膜炎和脑炎病人脑脊液肠道病毒RNA的检测及其临床意义

Detection of enterovirus RNA in cerebrospinal fluid from patients with aseptic meningitis and encephalitis and its clinical significance

目的 检测肠道病毒 (EV)在中枢神经系统感染中的致病情况 ,探讨检测EV感染的方法。方法 就用逆转录 聚合酶链反应 (RT PCR)和病毒培技术检测 46例无菌性脑膜炎及脑炎病人脑脊液 (CSF)标本。结果 RT PCR方法敏感特异 ;46例无菌性脑膜炎和脑炎急性期CSF标本中 ,31例EV阳性 (6 7 4% ) ,14例病毒培养阳性 (2 6 1% )。统计结果显示 ,RT PCR敏感性明显高于病毒培养。结论 EV是引起无菌性脑膜炎和脑炎的重要病原 ;RT PCR快速敏感特异 ,简单易行 ,易于推广 。

Objective To study the pathogenicity of enterovirus (EV) infection in central nervous system and the method for its detection. Methods Using revers transcription polymerase chain reaction (RT\|PCR) and viral culture techniques to detect EV from 46 cerebrospinal fluid (CSF) samples of aseptic meningitis and encephalitis patients. The sensitivity and specificity of RT\|PCR for EV RNA detection was affirmed by specific RNA identification of 40 strains of prototype enterovirus. Results By the virus culture method, 14 out of the 46 CSF sample were tested to be EV positive (26 1%) including 6 Echovirus type 2 (ECV2), 2 Coxackie virus type B2 (CVB2), 2CVB6, 1 ECV3 and 1 ECV11. By RT\|PCR method, 31 of 46 CSF sample were tested EV RNA positive (67 4%) trough amplified product agarose electrophoresis and northern blot hybridizition. The positive CSF included 14 samples that had been tested positive by virus culture and 17 samples that accounted for 53 9% of the 32 CSF samples which were negetive by virus culture. the sensitivity of RT\|PCR was statistically higher than that of the virus culture method, χ 2=12 57, P <0 01. Conclusion EV is known as important etiological agents of aseptic meningitis and encephalitis. RT\|PCR is sensitivity, specificity and rapidity, it may be popularized as an effective method to the detection of enterovirus.