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目的 探讨无菌性发热新生儿外周血单个核细胞 (PBMC)中肠道病毒 (EV)基因表达情况和临床表现特点。方法 采用逆转录聚合酶链反应 (RT PCR)、原位杂交和病毒分离技术检测了 2 9例发热待查组和 18例中枢感染组新生儿PBMC、脑脊液及血清中EVRNA ,并对其临床特点进行总结分析。结果 发热待查组EV感染 14例 (48 3% ) ,9例PBMC中EVRNA阳性者 ,血清中全部阳性 ,其中 4例脑脊液中同时阳性 ;中枢感染组EV感染 11例 (6 1 1% ) ,5例外周血PBMC中EVRNA阳性者 ,血清和脑脊液中也全部阳性。两组比较 ,只有RT PCR法检测中枢感染组脑脊液中EVRNA阳性数高于发热组 ,而不同方法检测PBMC和血清中EVRNA两组间差异均无显著性。EV感染的主要症状有喂养困难 (71% )、易激惹 (6 4 % )、腹泻 (6 1% )、嗜睡 (5 4 % )、肝脏肿大 (46 % )及皮疹(36 % )等。结论 EV可感染新生儿的PBMC ;新生儿感染后EV易在全身播散 ;临床表现不典型 ,早期、快速病原诊断可缩短住院天数和减少抗生素的应用 ,有较高的社会和经济效益。
Objective To investigate the gene expression and clinical features of enterovirus (EV) in peripheral blood mononuclear cells (PBMCs) from aseptic neonates with fever. Methods RT-PCR, in situ hybridization and virus isolation techniques were used to detect the EVRNA in 29 neonates with fever check group and 18 central infection group, and their clinical features Carry on the summary analysis. Results 14 patients (48.3%) had EV infection in fever group and 9 EVC positive PBMCs in PBMCs, all of them were positive in serum, 4 of them were positive in cerebrospinal fluid (CSF); 11 (61.1%) were EV in central infection group, 5 cases of peripheral blood PBMC EVRNA-positive, serum and cerebrospinal fluid are also all positive. Only the positive rate of EVRNA in cerebrospinal fluid of central infection group was higher than that of fever group by RT-PCR method, while there was no significant difference between the two groups in the detection of PBMC and serum EVRNA by different methods. The main symptoms of EV infection were feeding difficulties (71%), irritability (64%), diarrhea (61%), lethargy (54%), enlargement of the liver (46%) and skin rashes . Conclusion EV can infect neonates with PBMC. After neonatal infection, EV tends to spread throughout the body. The clinical manifestations are not typical. Early and rapid pathogen diagnosis can shorten the length of hospital stay and reduce the application of antibiotics, which has high social and economic benefits.