摘要
目的：探讨鼻病毒（HRV）作为儿童中枢神经系统感染病原学的意义及临床特点。方法收集2011年6月至2012年12月因发热、抽搐疑似中枢神经系统感染入儿科ICU的205例患儿脑脊液标本205份，应用GeXP多功能遗传分析系统行 HRV筛查，阳性结果行套式反转录‐PCR方法扩增、送基因测序，并对阳性病例进行临床资料分析。结果205份患儿脑脊液标本共检出HRV阳性7份，其中HRV‐A有2份，HRV‐B有1份，HRV‐C有4份（包括1份HRV‐Ca型）。7例患儿中，男6例、女1例，除1例9岁，另6例均＜3岁，发病时间主要集中在9至10月份，发热、抽搐为其主要临床表现，病原体检出前临床诊断为病毒性脑炎、癫痫、热性惊厥、轻度胃肠炎伴良性惊厥（CwG）和手足口病等。7例患儿的病情轻重不一，但预后均良好。结论 HRV是引起小儿中枢神经系统感染的病原体之一。各型HRV均可致脑炎，但以HRV‐C为主。HRV脑炎的临床表现可类似于热性惊厥、CwG和手足口病。
Objective To discuss the etiology and clinical characteristics of human rhinovirus （HRV） as pathogen of central nervous system infection .Methods Two hundred and five cerebrospinal fluid （CSF） specimens were collected from children with fever and convulsions who were admitted to the pediatric intensive care unit with suspicion of central nervous system infection from June 2011 to December 2012 .Genome Lab Genetic Analysis System （GeXP） was applied to detect HRV from CSF .Specimens with positive results were amplified by nested reverse transcription‐polymerase chain reaction and followed by gene sequencing . Clinical data of HRV positive cases were analyzed . Results Of the 205 CSF specimens ,7 samples were positive for HRV ,which were composed of 2 HRV‐A ,1 HRV‐B and 4 HRV‐C （including 1 HRV‐Ca） .There were 6 boys and 1 girl among the 7 positive cases for HRV .Six children were less than 3 years old ,except one was 9 years old .The onset time was mainly concentrated between September and October . The main clinical manifestations were fever and convulsions . The clinical diagnosis before the pathogen confirmation included viral encephalitis ,epilepsy ,febrile convulsion ,benign infantile convulsions with mild gastroenteritis （CwG ） and hand‐foot‐and‐mouth disease （ HFMD ） . Although the disease severity of the 7 cases varied ,all ended with favorable prognosis .Conclusions HRV is one of pathogens of viral central nervous system infection .All types of HRV can cause central nervous system infection ,among which HRV‐C accounts for the majority .The clinical manifestations of HRV central nervous system infection could mimic febrile convulsion ,CwG and HFMD .
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2015年第9期527-532,共6页
Chinese Journal of Infectious Diseases
基金
广东省医学科学技术研究基金（B2014281）
关键词
鼻病毒属
脑炎
病毒性
儿童
基因分型
临床分析
Rhinovirus
Encephalitis, viral
Child
Genotypic assay, Clinical analysis
