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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 To understand the epidemiological characteristics of human enterovirus 71 (EV71) in patients with encephalitis and provide guidance for prevention and control of clinical infection. Methods The clinical data and cerebrospinal fluid samples of 812 patients with encephalitis were collected. The EV71 virus was amplified by RT-PCR and the prevalence of EV71 virus was analyzed. Results The results of RT-PCR showed that 224 of 812 encephalitis patients were infected with EV71 virus, with a detection rate of 27.59%. The infection rate of EV71 virus in encephalitis patients in spring, summer, autumn and winter was 33.11%, 23.02%, 22.22% and 26.70%, respectively. The infection rate in spring was significantly different from other seasons (χ2 = 7.4741, P = 0.0063). The infection rates of male and female patients were 30.80% and 23.08%, respectively. The infection rates were statistically significant (χ2 = 5.8938, P = 0.0152). The infection rates of children, adolescents and middle-aged and elderly patients were 26.64%, 20.92% and 34.57% respectively. The infection rate in middle-aged and elderly patients was significantly different from other age groups (χ2 = 9.8285, P = 0.0017). 224 patients (81.25%), 164 (73.21%), 155 (69.20%), 63 (28.13%) patients with fever, vomiting, headache, diarrhea and nausea were the main clinical manifestations of 224 patients. 26 cases (11.61%), other clinical manifestations are not obvious. After the 224 patients were treated, 144 patients were cured or better discharged, no positive symptoms or signs were found at discharge. Conclusions Spring is the season of high incidence of EV71 virus encephalitis, and the majority of male patients are middle-aged and elderly patients. The main symptoms of patients with sudden onset, fever and other symptoms common.