脑炎患者感染EV71病毒的流行特点分析

Analysis of the epidemiological features of EV71 virus infecting patients with encephalitis

目的了解脑炎患者中感染人肠道病毒71型病毒(human enterovirus 71,EV71)流行特点,为临床感染防控提供指导。方法收集812例脑炎患者临床资料及脑脊液样本,采用RT-PCR扩增检测EV71病毒,分析EV71病毒流行情况。结果经RT-PCR检测,812例脑炎患者中有224例为EV71病毒感染,检出率27.59%。春、夏、秋、冬四季脑炎患者EV71病毒感染率为33.11%、23.02%、22.22%和26.70%,且春季感染率与其他季节相比,差异有统计学意义(χ2=7.4741,P=0.0063)。男性和女性患者感染率分别为30.80%和23.08%,感染率差异有统计学意义(χ2=5.8938,P=0.0152)。儿童、青少年、中老年患者感染率分别为26.64%、20.92%和34.57%;中老年患者感染率与其他年龄患者相比,差异有统计学意义(χ2=9.8285,P=0.0017)。224例患者主要临床表现为突然发病,发热、呕吐、头痛、腹泻、恶心患者分别有182例(81.25%)、164例(73.21%)、155例(69.20%)、63例(28.13%)和26例(11.61%),其他临床表现不明显。224例患者经治疗后,有144例治愈或好转出院,出院时均未发现阳性症状或体征。结论春季为EV71病毒脑炎高发季节,男性中老年患者居多。患者主要表现为突然发病,发热等症状常见。

Objective The epidemiological features of human enterovirus 71（EV71）infecting patients with encephalitis were studied to guide the prevention and control of clinical infections. Methods Clinical data and cerebrospinal fluid samples were collected from 812 patients with encephalitis.The EV71 virus was amplified with RT-PCR to analyze the prevalence of the virus. Results RT-PCR indicated that 224 of the 812 patients with encephalitis were infected with the EV71 virus,for a rate of detection of 27.59%.The rate of infection with the EV71 virus among patients with encephalitis was 33.11%in the spring,23.02%in the summer,22.22%in the autumn,and 26.70%in the winter.The rate of infection in the spring differed significantly from that in other seasons（χ^2=7.4741,P=0.0063）.The rate of infection was30.80%in male patients and 23.08% in female patients,and the rate of infection differed significantly by sex（χ^2=7.4741,P=0.0152）.The rate of infection was 26.64%in children,20.92%in young adults,and 34.57% in middleaged and elderly patients.The prevalence of infection in middle-aged and elderly patients differed significantly from that in patients of other ages（χ^2=9.8285,P=0.0017）.The main clinical feature in 224 patients was sudden onset.One hundred and eighty-two patients（81.25%）had a fever,164（73.21%）had vomiting,155（69.20%）had headaches,63（28.13%）had diarrhea,and 26（11.61%）had nausea,but other clinical features were not evident.Of 224 treated patients,144 recovered or sufficient improved to be discharged,and there were no symptoms or signs of EV71 infection upon discharge. Conclusion EV71 caused encephalitis primarily in the spring,and most patients were middle-aged or elderly males.The main clinical feature of infection was sudden onset,and other common symptoms included a fever.