摘要
目的通过宏基因组二代测序技术(mNGS)分析甘肃地区急性病毒性脑炎脑膜炎症候群(AVMES)的病原谱及发病特征。方法分析2018年1月1日—2020年12月30日甘肃省13家医院神经内科通过mNGS确诊为AVMES的患者的人口学特征及临床基线资料、检出病毒谱。结果 542例患者中男性301例(55.54%),女性241例(44.46%),患者发病年龄集中在18~65岁。脑脊液mNGS检测出人类疱疹病毒431例,占79.52%,全省各地散在分布,发病集中在2—3月及11—12月,其中主要是人类疱疹病毒1型;检测出肠道病毒79例(14.58%),多在河西地区(武威、金昌、敦煌、酒泉、嘉峪关),发病时间在7—9月,其中主要是肠道病毒71型。虫媒病毒均为乙型脑炎病毒,集中在7月,主要在陇东南地区分布(定西、天水、平凉、陇南)。人类疱疹病毒、肠道病毒、虫媒病毒在区域性分布、发病时间、临床症状和体征之间差异有统计学意义(P<0.001),人类疱疹病毒亚型分析显示,各亚型在性别、年龄、发病时间、临床症状和体征之间差异有统计学意义(P<0.05),肠道病毒亚型分析显示,各亚型仅在年龄、发病时间中差异有统计学意义(P <0.05)。结论甘肃省AVMES的病原体主要是人类疱疹病毒1型,乙型脑炎病毒主要在陇东南地区,肠道病毒主要在河西地区。
Objevtive To analyze the pathogenic spectra and characteristics of acute viral encephalitis meningitis syndrome(AVEMS) in Gansu Province by metagenomic next-generation sequencing(mNGS).Methods The demographic characteristics, clinical baseline data and the virus spectra were analyzed, from January 1, 2018, to December 30, 2020, of patients detected with AVEMS in the neurology departments of 13 hospitals in Gansu Province who were diagnosed by metagenomic second-generation sequencing. Results Of the 542 patients, 301 were male(55.54%), 241 female(44.46%). Cerebrospinal fluid NGS detected 431 cases of the human herpes virus by mNGS of cerebrospinal fluid, accounting for 79.52%, who were scattered throughout the province;the incidence was concentrated in February to March and November to December, in which the main herpes simplex virus type 1 was detected. 79 cases(14.58%) of the enterovirus were mostly distributed in the Hexi Corridor(Wuwei, Jinchang, Dunhuang, Jiuquan, Jiayuguan), the onset time was from July to September and the main type was enterovirus 71. The arboviruses were of Japanese encephalitis virus,concentrated in July and mainly distributed in the southeast of Gansu(Dingxi, Tianshui, Pingliang, Longnan).The regional distribution, time of onset, clinical symptoms and signs of human herpesvirus, enterovirus and arbovirus were statistically significant(P < 0.001). The analysis of human herpesvirus subtypes showed that different types of human herpesvirus were statistically significant in gender, age, time of onset, clinical symptoms and signs(P < 0.05). The analysis of enterovirus subtypes showed that only age and onset time of each subtype had statistical significance(P < 0.05). Conclusion The main pathogen spectrum of AVMES was herpes simplex virus-1, and Japanese encephalitis virus was in the southeast of Gansu and enterovirus in the Hexi Corridor.
作者
李鑫
栗静
武国德
王满侠
蒋珍秀
陈合成
俞登虎
彭炜
刘莉莉
龚海燕
温世斌
鲁进强
周翔宇
马国平
杨旭
巩海涛
王旭霞
Li Xin;Li Jing;Wu Guo-de;Wang Man-xia;Jiang Zhen-xiu;Cheng He-cheng;Yu Deng-hu;Peng Wei;Liu Li-li;Gong Hai-yan;Wen Shi-bin;Lu Jin-qiang;Zhou Xiang-yu;Ma Guo-ping;Yang Xu;Gong Hai-tao;Wang Xu-xia(Department of Neurology,The Second Hospital of Lanzhou University,Lanzhou 730030,China;Department of Neurology,The First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Neurology,Gansu Provincal Hospital,Lanzhou 730000,China;Department of Neurology,Gulang People's Hospital,Wuwei 733100,Gansu,China;Department of Neurology,Wuwei People's Hospital,Wuwei 733000,Gansu,China;Department of Neurology,Jingchang People's Hospital,Jingchang 737100,Gansu,China;Department of Neurology,The Hospital of Dunhuang City,Dunhuang 736200,Gansu,China;Department of Neurology,Jiuquan People's Hospital,Jiuquan 735000,Gansu,China;Department of Neurology,Affiliated Hospital of Jiuquan Iron and Steel Group Co.,Ltd,Jiayuguan,735100,Gansu,China;Department of Neurology,Qin'an People's Hospital,Tianshui 741600,Gansu,China;Department of Neurology,Tianshui People's Hospital,Tianshui 741000,Gansu,China;Department of Neurology,Minxian Hosptial of Traditional Chinese Medicine,Dingxi 748400,Gansu,China;Department of Neurology,No.1 Hospital of Longnan,Longnan 742500,Gansu,China;Institute of Health Education,Gansu Center for Disease Control and Presention,Lanzhou 730000,China)
出处
《兰州大学学报（医学版）》
2021年第6期53-61,共9页
Journal of Lanzhou University（Medical Sciences）
基金
甘肃省自然科学基金资助项目(21JR1RA136)。
关键词
病毒性脑炎
病毒性脑膜炎
病原谱
宏基因组二代测序
viral encephalitis
viral meningitis
pathogen spectrum
metagenomic next-generation sequencing
