CAJ | 학술논문

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IC U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 H RV 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 H RV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。
목적：탐토비병독（HRV ）작위인동중추신경계통감염병원학적의의급림상특점。방법수집2011년6월지2012년12월인발열、추휵의사중추신경계통감염입인과IC U적205례환인뇌척액표본205빈，응용GeXP다공능유전분석계통행 HRV사사，양성결과행투식반전록‐PCR방법확증、송기인측서，병대양성병례진행림상자료분석。결과205빈환인뇌척액표본공검출 H RV 양성7빈，기중 HRV‐A유2빈，HRV‐B 유1빈，HRV‐C유4빈（포괄1빈 HRV‐Ca형）。7례환인중，남6례、녀1례，제1례9세，령6례균＜3세，발병시간주요집중재9지10월빈，발열、추휵위기주요림상표현，병원체검출전림상진단위병독성뇌염、전간、열성량궐、경도위장염반량성량궐（CwG）화수족구병등。7례환인적병정경중불일，단예후균량호。결론 H RV시인기소인중추신경계통감염적병원체지일。각형HRV균가치뇌염，단이 HRV‐C위주。 HRV뇌염적림상표현가유사우열성량궐、CwG화수족구병。
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 .