摘要
目的探讨以精神行为异常为主要起病方式的脑炎患者与博尔纳病病毒（BDV）感染的相关性，分析感染BDV的脑炎患者临床特征。方法采用荧光定量巢式逆转录聚合酶链反应方法检测36例有精神行为异常的脑炎患者（患者组）外周血和脑脊液有核细胞中BDVp24和BDVp40基因片段。以B-肌动蛋白作为内参照，同时检测34名健康体检者的外周血和30例实行腰麻患者的脑脊液（对照组）有核细胞中BDVp24和BDVp40基因片段。对BDVp24和BDVp40基因片段均为阳性的标本进行基因测序分析，外周血进行BDV抗体滴度测定，对患者的精神症状采用阳性与阴性症状量表评分，并总结阳性患者的临床特征。结果4例以精神行为异常为主要起病方式的脑炎患者外周血和脑脊液标本BDVp24、BDVp40基因片段检测均为阳性，阳性率为11．1％（4／36），有1例脑脊液BDVp24阳性而外周血单个核细胞中BDVp40基因片段检测阴性，拷贝数均〉10^2kb／山。对照组检测BDVp24、BDVp40基因片段均为阴性（0／34、0／30），两组阳性率比较差异有统计学意义（P=0．015）。对BDVp24和BDVp40基因片段均为阳性的标本进行测序后，发现与马源的BDV病毒株亲缘关系最近。阳性标本的精神症状主要以幻觉、妄想等阳性症状为主，阳性与阴性症状量表评分均在40分以上。结论以精神行为异常起病的脑炎患者与BDV感染有一定的相关性。BDV感染患者主要以阳性精神症状为主。
Objective To discuss the relationship between Borna disease virus （BDV） infection and the patients of encephalitis with mental and behavioral disorders, as well as to analyze the clinical features of patients infected by BDV. Methods The p24 and p40 gene fragment of BDV in 36 patients with encephalitis, 34 healthy donors and 30 patients with spinal anaesthesia were examined in peripheral blood mononuclear cells （PBMCs） and cerebrospinal fluid mononuclear cells by nested fluorescence quantitative- nest reverse transcription-PCR. In the meantime, β-actin in specimens was detected by PCR as an internal reference. The clinical characteristics of patients with encephalitis with mental and behavioral disorders infected by BDV were summarized. The patients with positive mental symptoms were given a mark with the Positive And Negative Syndrome Scale. Results The positive rate （4/36, 11.1% ） of BDVp24 and BDVp40 in PBMCs and cerebrospinal fluid mononuclear cells in mental encephalitis was significantly higher than that in healthy donors and patients with spinal anaesthesia （0/34, 0/30; P = 0. 015） ,and the number of copies of BDVp24 and BDVp40 in PBMCs was more than 102 kh/μl. One patient was positive in cerebrospinal fluid of BDVp24 gene fragment but was negative in PBMCs of BDVp40. The homologies of the gene sequence of positive product were genetically related to the virus strain BDV from horse. The clinicalfeatures of encephalitis patients with positive products were mainly hallucination and delusion. Conclusions BDV infection is correlated with encephalitis patients with mental and behavioral disorders. The clinical features of patients with BDV infection were mainly positive mental symptoms.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2015年第4期307-311,共5页
Chinese Journal of Neurology
基金
湖南省科技基金资助项目
