| 摘要: |
| 目的分析2015年夏季杭州地区新生儿肠道病毒脑炎病原分型及临床特征。方法选择浙江大学医学院附属儿童医院2015年5-9月收治的45例有颅内感染的新生儿为研究对象，采用RT-PCR法检测脑脊液中的肠道病毒，根据结果分为病例组（阳性）与对照组（阴性），比较与分析新生儿肠道病毒脑炎病原分型及临床特征。结果45例患儿脑脊液中检出肠道病毒阳性17例（37.8%）。病例组脑脊液中糖含量高于对照组（P＜0.05），蛋白含量少于对照组（P＜0.05）；两组患者发热、黄疸、呕吐、抽搐等临床症状比较，差异均无统计学意义（均P＞0.05）。将17例脑脊液肠道病毒阳性标本进行基因分析，得到埃可病毒（ECHO）30（13例）、ECHO16（2例）和柯萨奇病毒（CV）B2（2例）；对上述临床株进行进化树分析，发现与参考株的同源性达89.6%~98.3%。结论2015年夏季杭州地区新生儿肠道病毒脑炎局部暴发流行，脑脊液生化指标的变化符合病毒性脑炎的特点，但临床表现无明显特异性；ECHO30是主要病原体，进化树分析显示本次暴发流行可能是浙江省ECHO30分离株的又一暴发流行。 |
| 关键词: 肠道病毒脑炎 新生儿 病原分型 临床特征 |
| DOI：10.12056/j.issn.1006-2785.2017.39.23.2016-1690 |
| 分类号: |
| 基金项目:浙江省医药卫生一般计划项目（2015KYA119） |
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| Pathogenic genotypes and clinical features of neonatal enterovirus-associated encephalitis in Hangzhou 2015 |
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Tongde Hospital of Zhejiang Province
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| Abstract: |
| Objective To analyze the pathogenic genotypes and clinical features of neonatal enterovirus-associated encephalitis in Hangzhou 2015. Methods Forty five newborns with intracranial infection admitted in Children's Hospital, Zhejiang University School of Medicine from May to September 2015 were enrolled in this study. The cerebrospinal fluid(CSF) samples from these newborns were collected and tested by RT-PCR. The pathogenic genotypes and clinical features of patients were analyzed. Results The enterovirus was positive in 17 CSF specimens (case group) with a positive rate of 37.8%. The glucose
concentration in CSF of the case group was significantly higher (P＜0.05), however, the protein content in CSF of case group was
significantly lower than those of control group (P＜0.05). There were no significant in clinical symptoms, including fever, jaundice, vomiting and cramps between case and control groups (P ＞0.05). Among 17 cases with positive intestinal virus in CSF, the Echo 30 virus was detected in 13 cases (76.5%), Echo 16 virus in 2 cases (11.8%) and CVB 2 virus in 2 cases (11.8%). Phylogenetic tree analysis showed that the homology between clinical isolates and reference strains was 89.6%-98.3%. Conclusion Echo 30 is the main pathogen of the outbreak of viral encephalitis among newborns in the summer of 2015 in Hangzhou. |
| Key words: Enterovirus encephalitis Newborns Pathogen parting Clinical features |
