Christensen Andreas, Nordbø Svein Arne
Laboratorium for medisinsk mikrobiologi, St Olavs Hospital, Trondheim.
Tidsskr Nor Laegeforen. 2003 Nov 20;123(22):3180-3.
Enteroviruses comprise polioviruses, coxsackieviruses, ECHO viruses and the newer enteroviruses. Poliovirus is now declared eradicated from Europe, but viruses from the other three groups are still frequent causes of human diseases, ranging from mild upper respiratory infections to multi-organ failure.
We present a survey of 438 patients with enteroviral diseases diagnosed from 1992 to 2001. Enteroviral infections were diagnosed by polymerase chain reaction, isolation by tissue culture, and in a few cases by electron microscopy. Clinical information was gathered from referral forms and patient files. 172 of the isolates were typed.
Meningitis, gastroenteritis, respiratory disease and fever were the most frequent diseases. ECHO virus 30, ECHO virus 6 and coxsackievirus A16 were the most common serotypes. 33 % of patients were younger than two years of age.
Our clinical data demonstrate the wide spectrum of diseases that enterovirus infections may cause. We have found a relatively high proportion of patients with encephalitis. The association between enterovirus and gastroenteritis is discussed. Enteroviruses are the most common cause of aseptic meningitis; enterovirus polymerase chain reaction should be performed routinely when dealing with this disease. Our data also illustrate the superior sensitivity of polymerase chain reaction compared to culture, though culturing is still needed as a source of supplementary information.
肠道病毒包括脊髓灰质炎病毒、柯萨奇病毒、埃可病毒和新型肠道病毒。脊髓灰质炎病毒现已宣布在欧洲根除,但其他三组病毒仍是人类疾病的常见病因,范围从轻度上呼吸道感染到多器官衰竭。
我们对1992年至2001年诊断的438例肠道病毒疾病患者进行了一项调查。肠道病毒感染通过聚合酶链反应诊断,通过组织培养分离,少数情况下通过电子显微镜诊断。临床信息从转诊表和患者档案中收集。对172株分离株进行了分型。
脑膜炎、胃肠炎、呼吸道疾病和发热是最常见的疾病。埃可病毒30型、埃可病毒6型和柯萨奇病毒A16型是最常见的血清型。33%的患者年龄小于两岁。
我们的临床数据证明了肠道病毒感染可能导致的疾病范围广泛。我们发现脑炎患者的比例相对较高。讨论了肠道病毒与胃肠炎之间的关联。肠道病毒是无菌性脑膜炎最常见的病因;在处理这种疾病时应常规进行肠道病毒聚合酶链反应。我们的数据还说明了聚合酶链反应与培养相比具有更高的敏感性,尽管仍需要培养作为补充信息的来源。