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目的探讨肠道病毒所致病毒性脑炎(肠道病毒脑炎)在各个季节的分布及临床特点。方法 全部病毒性脑炎患者在疾病的急性期留取脑脊液,按比例在每季节各随机抽取15例、42例、14例和9例患儿,以PCR法检测肠道病毒,观察肠道病毒脑炎的流行病学特点及临床特征。结果①80例患儿中肠道病毒PCR阳性22例(27.5%),其中春季13.3%(2/15),夏季35.7%(15/42),秋季26.7%(4/14),冬季11.1%(1/9)。②肠道病毒感染者和非肠道病毒感染者脑脊液、头颅CT与脑电图的异常情况差异无统计学意义(P>0.05)。③临床情况:两组发热、惊厥和意识方面比较,差异无统计学意义(P>0.05);皮肤肌肉刺痛、口角或咽峡疱疹、扁桃体灰白小点及心肌损害方面,两组比较差异有统计学意义(P<0.01);肝功能损害方面,两组比较差异有统计学意义(P<0.05)。结论①肠道病毒脑炎和非肠道病毒所致病毒性脑炎在季节分布、脑脊液常规、脑脊液生化、头颅CT、脑电图及发热、惊厥、意识改变等方面无显著差异;②肠道病毒脑炎较易出现肌肉刺痛、咽峡黏膜疱疹及心、肝功能损害,患儿扁桃体上可见灰白斑点。
Objective To investigate the distribution and clinical features of viral encephalitis (enterovirus encephalitis) caused by enterovirus in different seasons. Methods All patients with viral encephalitis were given cerebrospinal fluid (CSF) during the acute phase of the disease. Fifteen cases were randomly selected in each season, 42 cases, 14 cases and 9 cases of children. The enterovirus was detected by PCR and the enterovirus Epidemic characteristics and clinical features of encephalitis. Results ① The positive rate of enterovirus PCR in 22 children (27.5%) was found in 80 cases, of which 13.3% (2/15) in spring, 35.7% (15/42) in summer, 26.7% (4/14) in autumn and 11.1% 1/9). ② There was no significant difference in cerebrospinal fluid (CSF), cranial CT and EEG between patients with enterovirus infection and those with non-enterovirus infection (P> 0.05). ③ clinical situation: fever, convulsion and consciousness between the two groups, the difference was not statistically significant (P> 0.05); skin muscle stabbing, mouth or swollen herpes, tonsil gray spots and myocardial damage, the difference between the two groups are (P <0.01). There was significant difference between the two groups in terms of liver dysfunction (P <0.05). Conclusions ①Viral encephalitis caused by enterovirus encephalitis and non-enterovirus has no significant difference in seasonal distribution, cerebrospinal fluid routine, cerebrospinal fluid biochemistry, cranial CT, EEG, fever, convulsion and change of consciousness. Virus encephalitis is more prone to muscle tingling, pharyngeal gland mucosal herpes and heart and liver damage, children with tonsil visible gray spots.