2015年天津市实验室确诊病毒性脑炎流行病学调查

Epidemiological survey on laboratory confirmed viral encephalitis in Tianjin in 2015

目的探讨实验室确诊病毒性脑炎的流行特征及经济负担,为做好监测、防控和治疗提供理论依据。方法 2015年,天津市哨点医院就诊的病毒性脑炎患者进行流行病学调查,采集血清和/或脑脊液样本,采用RT-PCR和/或ELISA方法进行病原学检测,对实验室确诊的病毒性脑炎开展经济负担调查。结果2015年,天津市实验室确诊的病毒性脑炎患者44例,其中肠道病毒阳性23例(52.27%),单纯疱疹病毒阳性12例(27.27%),腮腺炎病毒阳性7例(15.91%),巨细胞病毒阳性2例(4.55%)。<10岁患者最多,19例(43.18%),20~岁组14例(31.82%)。学生患者数最多13例(29.55%),其中单纯疱疹病毒阳性5例(38.46%),腮腺炎病毒阳性4例(30.77%)。全年均有发病,5~9月监测32例,占全年的72.73%。不同年龄组人群中住院时间(F=6.25,P=0.001 5);住院费用(F=4.03,P=0.013 9)和间接费用(F=2.91,P=0.047)差异均有统计学意义。结论天津市病毒性脑炎主要的病原体是肠道病毒,其次是单独疱疹病毒和腮腺炎病毒。病毒性脑炎造成的经济负担较重,应加强病毒性脑炎的监测,做到早诊断、早治疗。

Objective To understand the epidemiological characteristics of laboratory confirmed viral encephalitis,and to discuss the financial burden of the disease.Methods A survey was conducted among patients with viral encephalitis in five sentinel hospitals in Tianjin in 2015.Blood samples and/or cerebrospinal fluid specimens were collected and sent to Tianjin CDC for etiological determination by RT-PCR and/or ELISA,and conducted a survey on financial burden of patients with laboratory confirmed viral encephalitis.ResultsIn 2015,44 cases were laboratory confirmed cases of viral encephalitis.Enterovirus,HSV（Ⅰ ＋Ⅱ）,Mumps and CMV were detected in 23,12,7and 2cases,respectively.Majority of patients（43.18%）were younger than 10 years old and 31.82% of cases were in the age group of 20-29 years.29.55% of patients were students and HSV was the most common pathogen,followed by mumps virus.32 out of 44 patients appeared in May to September,accounting for 72.73% of the total cases.The differences of hospital length of stay,hospital expenses and indirect costs were statistically significant among patients in different age groups（F=6.25,P=0.001 5;F=4.03,P=0.013 9;F=2.91,P=0.047）.Conclusions Enterovirus is the major pathogen of viral encephalitis in Tianjin,followed by herpes virus and the mumps virus.Viral encephalitis is a disease posting a heavy financial burden to patients.Therefore,disease monitoring should be enhanced in order to diagnose and treat patients as early as possible.