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目的 探讨无菌性脑炎发病与肠道病毒感染的关系。方法 对 1994年苍山县和 1996年栖霞市发生的两起无菌性脑炎暴发病例和 1996年 7月～ 1997年 3月济南市两所医院无菌性脑炎住院病例进行流行病学和临床特征的调查 ,并采集部分病例粪便或脑脊液标本进行肠道病毒分离或 /和PCR检测。结果 无菌性脑炎的高发季节为春夏季或夏秋季 ,主要发病年龄为婴幼儿和小学生 ;临床以发热和神经系统症状为主 ,而少见腹泻与皮疹等前驱症状 ,多数病例的病程较短 (10～ 19天 )且预后较好 ,个别病例发生死亡。两起无菌性脑炎暴发病例的粪便标本病毒分离分别以CoxB3 和CoxB5病毒为优势毒株 ,初步判定为CoxB病毒引致的病毒性脑炎 ;对住院的无菌性脑炎病例脑脊液标本进行PCR检测 ,其中 8例CoxB病毒为阳性 ,且 3例分离到CoxB3 病毒 ,故这 8例病例确诊为CoxB病毒引致的病毒性脑炎。结论 CoxB病毒是导致我省局部地区病毒性脑炎流行的主要病原 ,今后应加强肠道病毒引起的病毒性脑炎的监测和防治研究工作
Objective To investigate the relationship between the incidence of aseptic encephalitis and enterovirus infection. Methods Two epidemic cases of aseptic encephalitis in Cangshan County and Qixia City in 1994 and inpatients with aseptic encephalitis in two hospitals in Jinan City from July 1996 to March 1997 were studied. Characteristics of the survey and collection of some cases of fecal or cerebrospinal fluid samples for enterovirus isolation and / or PCR detection. Results The highest incidence of aseptic encephalitis was in spring, summer, summer and autumn, with the main age of onset being infants and young children, clinical symptoms of fever and nervous system, and rare prodromal symptoms such as rare diarrhea and rash. The majority of cases had shorter duration (10 to 19 days) and the prognosis is good, some cases of death. Two cases of aseptic encephalitis outbreak cases of stool specimens were isolated virus CoxB3 and CoxB5 virus as the dominant strain, initially identified as CoxB virus-induced viral encephalitis; hospitalized cases of aseptic encephalitis cerebrospinal fluid samples were PCR 8 of them were positive for CoxB virus and 3 of them were isolated for CoxB3 virus. Therefore, 8 cases were confirmed as CoxB virus-induced viral encephalitis. Conclusions CoxB virus is the main pathogen that causes epidemic of viral encephalitis in some areas of our province. In the future, we should strengthen the research on the monitoring and prevention of viral encephalitis caused by enteroviruses