水痘带状疱疹病毒：儿童和成人中风的常见病因。
Varicella Zoster Virus: A Common Cause of Stroke in Children and Adults.
作者信息
Amlie-Lefond Catherine, Gilden Don
机构信息
Department of Neurology, Seattle Children's Hospital, University of Washington, Seattle, Washington.
Departments of Neurology and Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado.
出版信息
J Stroke Cerebrovasc Dis. 2016 Jul;25(7):1561-1569. doi: 10.1016/j.jstrokecerebrovasdis.2016.03.052. Epub 2016 Apr 29.
BACKGROUND
Varicella zoster virus (VZV) is a neurotropic, exclusively human herpesvirus. Primary infection causes varicella (chickenpox), after which the virus becomes latent in ganglionic neurons along the entire neuraxis. As cell-mediated immunity to VZV declines with advancing age and immunosuppression, VZV reactivates to produce zoster (shingles). One of the most serious complications of zoster is VZV vasculopathy.
METHODS
We reviewed recent studies of stroke associated with varicella and zoster, how VZV vasculopathy is verified virologically, vaccination to prevent varicella and immunization to prevent zoster, and VZV in giant cell arteritis (GCA).
FINDINGS
We report recent epidemiological studies revealing an increased risk of stroke after zoster; the clinical, laboratory, and imaging features of VZV vasculopathy; that VZV vasculopathy is confirmed by the presence of either VZV DNA or anti-VZV IgG antibody in cerebrospinal fluid; special features of VZV vasculopathy in children; vaccination to prevent varicella and immunization to prevent zoster; and the latest evidence linking VZV to GCA.
CONCLUSION
In children and adults, VZV is a common cause of stroke.
背景
水痘带状疱疹病毒（VZV）是一种嗜神经性、仅感染人类的疱疹病毒。初次感染会引发水痘（带状疱疹），此后该病毒会在沿整个神经轴的神经节神经元中潜伏。随着年龄增长和免疫抑制导致针对VZV的细胞介导免疫下降，VZV会重新激活并引发带状疱疹（缠腰龙）。带状疱疹最严重的并发症之一是VZV血管病变。
方法
我们回顾了近期关于水痘和带状疱疹相关中风的研究、如何通过病毒学方法证实VZV血管病变、预防水痘的疫苗接种和预防带状疱疹的免疫接种，以及巨细胞动脉炎（GCA）中的VZV。
研究结果
我们报告了近期的流行病学研究，揭示了带状疱疹后中风风险增加；VZV血管病变的临床、实验室和影像学特征；脑脊液中存在VZV DNA或抗VZV IgG抗体可确诊VZV血管病变；儿童VZV血管病变的特殊特征；预防水痘的疫苗接种和预防带状疱疹的免疫接种；以及将VZV与GCA联系起来的最新证据。
结论
在儿童和成人中，VZV是中风的常见病因。
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