目的通过血清学诊断,了解乙脑发病情况;并对确诊的乙脑病例按照入院诊断进行分析,为今后乙脑的防控工作提供依据。方法对2006-2015年宜昌市6所病原学监测医院采集的血液、脑脊液标本进行乙型脑炎检测,了解乙脑发病情况,并对确诊的乙脑病例按入院诊断分为确诊组和漏诊组,分析两组在流行特征、临床表现、临床实验室常规检测指标方面的差异。结果共确诊61例乙脑病例,发病呈逐年下降趋势;确诊病例入院诊断以非乙脑为主;诊断组(n=18)与漏诊组(n=43)比较发现,两组在年龄和季节分布上差异有统计学意义(P<0.05);临床症状和体征方面,嗜睡、意识障碍、抽搐和脑膜刺激征方面发生诊断组高于漏诊组,差异有统计学意义(P<0.05);在实验室常规指标方面,脑脊液白细胞含量漏诊组明显高于诊断组,差异有统计学意义(P<0.05)。结论宜昌地区乙脑发病率逐年降低。但是医疗机构对乙脑病例漏诊严重,特别是大年龄儿童、成人及临床症状和体征较轻者容易发生漏诊,应提高医疗机构的诊断水平,开展乙脑的IgM实验室检测。 Objective To understand the incidence of Japanese encephalitis through serological diagnosis, and to analyze the diagnosed cases of Japanese encephalitis according to the diagnosis of admissions, so as to provide basis for future prevention and control of Japanese encephalitis. Methods The blood and cerebrospinal fluid samples collected from 6 etiological monitoring hospitals in Yichang City from 2006 to 2015 were tested for encephalitis B and the incidence of Japanese encephalitis was analyzed. According to the diagnosis of Japanese encephalitis, the diagnosed cases were divided into the diagnosis group and the missed diagnosis group , Analysis of the two groups in the characteristics of the epidemic, clinical manifestations, clinical laboratory routine test indicators differences. Results A total of 61 cases of JE were diagnosed with a decreasing trend year by year. The diagnosis of non-JE was mainly based on the diagnosis of non-JE in the diagnosis group (n = 18) and the missed diagnosis group (n = 43) There were significant differences in distribution between the two groups (P <0.05). In terms of clinical symptoms and signs, the incidence of lethargy, disturbance of consciousness, convulsion and meningeal irritation were higher in diagnosis group than in missed diagnosis group (P <0.05) Laboratory routine indicators, the level of cerebrospinal fluid leukocyte misdiagnosis was significantly higher than the diagnosis group, the difference was statistically significant (P <0.05). Conclusion The incidence of Japanese encephalitis in Yichang is decreasing year by year. However, medical institutions have serious misdiagnosis of Japanese encephalitis cases, especially in older children, adults and patients with less clinical symptoms and signs. Diagnosis should be improved in medical institutions and IgM laboratory testing of Japanese encephalitis should be conducted.