病毒性脑炎诊断的最新进展
Advances in the Diagnosis of Viral Encephalitis
DOI: 10.12677/acm.2024.1482203, PDF,    科研立项经费支持
作者: 姜 博*：北华大学附属医院泌尿外科，吉林 吉林；王玲玲：北华大学附属医院神经内科，吉林 吉林；庞未丽#：北华大学附属医院神经内科，吉林 吉林；武汉市江夏区第一人民医院神经介入科，湖北 武汉
关键词: 病毒性脑炎；癫痫；诊断；预后；Viral Encephalitis； Epilepsy； Diagnosis； Prognosis
摘要: 病毒性脑炎是中枢神经系统常见的感染性疾病。目前主要通过患者的临床表现、脑电图、脑脊液检查，同时结合影像学和病原学检查结果确诊。部分患者治疗后遗留有精神症状、癫痫等的神经系统后遗症，严重影响患者的预后。因此，早期诊断并优化治疗方案是降低疾病不良预后的关键。本文就病毒性脑炎诊断技术的最新进展做一综述。
Abstract: Viral encephalitis is a prevalent infectious disorder of the central nervous system. Recently, the diagnosis was confirmed by clinical manifestations, EEG, cerebrospinal fluid examination, combined with imaging and etiological examination results. Some patients have neurological sequelae such as residual mental symptoms and epilepsy after treatment, which seriously affect the prognosis. Therefore, early diagnosis and optimal treatment are key to reducing the adverse prognosis of the disease. This article reviews the latest progress in the diagnosis of viral encephalitis.
文章引用：姜博, 王玲玲, 庞未丽. 病毒性脑炎诊断的最新进展[J]. 临床医学进展, 2024, 14(8): 217-222. https://doi.org/10.12677/acm.2024.1482203

参考文献

[1] Venkatesan, A. (2015) Epidemiology and Outcomes of Acute Encephalitis. Current Opinion in Neurology, 28, 277-282. [Google Scholar] [CrossRef] [PubMed]
[2] 张少浩, 朱勇冬, 林麒. 病毒性脑炎217例症状性癫痫发生风险的预测研究[J]. 安徽医药, 2024, 28(7): 1430-1434.
[3] 卢紫芬, 曾卓鹏, 彭亚娟, 等. 脑电图鉴别诊断病毒性脑炎及预后评估的应用价值[J]. 影像研究与医学应用, 2021, 5(22): 235-236.
[4] 张文化, 李艳玲, 王亮, 等. 80例儿童病毒性脑炎病原学结果、脑电图表现及影像学特征[J]. 哈尔滨医科大学学报, 2024, 58(2): 198-202.
[5] 章镭. 病毒性脑炎的脑电图分析[J]. 现代电生理学杂志, 2014, 21(1): 39-42.
[6] 桂芹, 周红梅. 脑电图在病毒性脑炎诊断中的临床意义[J]. 重庆医学, 2006, 35(22): 2027+2029.
[7] 范连荣. 动态脑电图与常规脑电图诊断病毒性脑炎的准确率比照观察[J]. 影像研究与医学应用, 2021, 5(6): 248-249.
[8] 严波, 张家堂, 赵威, 等. 病毒性脑炎124例脑脊液分析[J]. 解放军医学院学报, 2014, 35(5): 430-432.
[9] 龚守会, 曹治华, 宋金辉, 等. 病毒性脑炎患者脑脊液检测分析[J]. 脑与神经疾病杂志, 2008, 16(6): 694-696.
[10] Yong, H.Y.F., Pastula, D.M. and Kapadia, R.K. (2023) Diagnosing Viral Encephalitis and Emerging Concepts. Current Opinion in Neurology, 36, 175-184. [Google Scholar] [CrossRef] 
[11] 赵德明. 脑脊液细胞学检查对病毒性脑炎的诊断价值[J]. 蚌埠医学院学报, 2002, 27(1): 45-46.
[12] Chiu, C.Y. and Miller, S.A. (2019) Clinical Metagenomics. Nature Reviews Genetics, 20, 341-355. [Google Scholar] [CrossRef] [PubMed]
[13] Hu, F., Wang, J. and Peng, X. (2020) Bilateral Necrotizing Retinitis Following Encephalitis Caused by the Pseudorabies Virus Confirmed by Next-Generation Sequencing. Ocular Immunology and Inflammation, 29, 922-925. [Google Scholar] [CrossRef] [PubMed]
[14] Perlejewski, K., Popiel, M., Laskus, T., Nakamura, S., Motooka, D., Stokowy, T., et al. (2015) Next-Generation Sequencing (NGS) in the Identification of Encephalitis-Causing Viruses: Unexpected Detection of Human Herpesvirus 1 While Searching for RNA Pathogens. Journal of Virological Methods, 226, 1-6. [Google Scholar] [CrossRef] [PubMed]
[15] Liu, L., Guo, L., Dong, J., Huang, W., Zhao, L., Liu, B., et al. (2019) Next-Generation Sequencing Technology as a Powerful Detection and Semi-Quantitative Method for Herpes Simplex Virus Type 1 in Pediatric Encephalitis. Journal of NeuroVirology, 26, 273-276. [Google Scholar] [CrossRef] [PubMed]
[16] Inagaki, T., Satoh, M., Fujii, H., Yamada, S., Shibamura, M., Yoshikawa, T., et al. (2018) Acyclovir Sensitivity and Neurovirulence of Herpes Simplex Virus Type 1 with Amino Acid Substitutions in the Viral Thymidine Kinase Gene, Which Were Detected in the Patients with Intractable Herpes Simplex Encephalitis Previously Reported. Japanese Journal of Infectious Diseases, 71, 343-349. [Google Scholar] [CrossRef] [PubMed]
[17] Gu, J., Chen, L., Zeng, C., Yang, X., Pan, D., Cao, H., et al. (2022) A Retrospective Analysis of Metagenomic Next Generation Sequencing (mNGS) of Cerebrospinal Fluid from Patients with Suspected Encephalitis or Meningitis Infections. Journal of Healthcare Engineering, 2022, 1-6. [Google Scholar] [CrossRef] [PubMed]
[18] Zhang, J., Zheng, P., Sun, H., Dong, J., Li, S., Fan, S., et al. (2019) Next-Generation Sequencing Combined with Routine Methods to Detect the Pathogens of Encephalitis/meningitis from a Chinese Tertiary Pediatric Neurology Center. Journal of Infection, 78, 409-421. [Google Scholar] [CrossRef] [PubMed]
[19] Wilson, M.R., Sample, H.A., Zorn, K.C., Arevalo, S., Yu, G., Neuhaus, J., et al. (2019) Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis. New England Journal of Medicine, 380, 2327-2340. [Google Scholar] [CrossRef] [PubMed]
[20] 王丽敏. 甲泼尼龙冲击联合丙种球蛋白治疗儿童重症病毒性脑炎的临床效果分析[J]. 大医生, 2024, 9(3): 55-57.
[21] 孔延亮, 黄勇, 胡重灵, 等. 病毒性脑炎的CT和MRI诊断价值研究及对比分析[J]. 中国CT和MRI杂志, 2016, 14(12): 7-9.
[22] Sener, R.N. (2001) Herpes Simplex Encephalitis: Diffusion MR Imaging Findings. Computerized Medical Imaging and Graphics, 25, 391-397. [Google Scholar] [CrossRef] [PubMed]
[23] Takanashi, J., Sugita, K., Ishii, M., Aoyagi, M. and Niimi, H. (1997) Longitudinal MR Imaging and Proton MR Spectroscopy in Herpes Simplex Encephalitis. Journal of the Neurological Sciences, 149, 99-102. [Google Scholar] [CrossRef] [PubMed]
[24] 彭娟, 罗天友, 吕发金, 等. 病毒性脑炎的核磁共振成像、扩散加权成像和质子MR波谱表现[J]. 第三军医大学学报, 2009, 31(3): 257-260.
[25] Zawadzki, R., Kubas, B., Hładuński, M., Zajkowska, O., Zajkowska, J., Jurgilewicz, D., et al. (2019) Proton Magnetic Resonance Spectroscopy (1H-MRS) of the Brain in Patients with Tick-Borne Encephalitis. Scientific Reports, 9, Article No. 2839. [Google Scholar] [CrossRef] [PubMed]
[26] 巴庆华. 病毒性脑炎脑脊液病毒特异性抗体ELISA检测结果分析[J]. 中国病原生物学杂志, 2013, 8(10): 944-945+948.
[27] DeBiasi, R.L. and Tyler, K.L. (2004) Molecular Methods for Diagnosis of Viral Encephalitis. Clinical Microbiology Reviews, 17, 903-925. [Google Scholar] [CrossRef] [PubMed]
[28] Green, M.R. and Sambrook, J. (2019) Nested Polymerase Chain Reaction (Pcr). Cold Spring Harbor Protocols, 2019, pdb.prot095182. [Google Scholar] [CrossRef] [PubMed]
[29] Pisano, M.B., Seco, M.P.S., Ré, V.E., Farías, A.A., Contigiani, M.S. and Tenorio, A. (2012) Specific Detection of All Members of the Venezuelan Equine Encephalitis Complex: Development of a RT-Nested PCR. Journal of Virological Methods, 186, 203-206. [Google Scholar] [CrossRef] [PubMed]
[30] Shen, X., Qiu, F., Zhao, H., Yang, M., Hong, L., Xu, S., et al. (2018) A Novel and Highly Sensitive Real-Time Nested RT-PCR Assay in a Single Closed Tube for Detection of Enterovirus. Diagnostic Microbiology and Infectious Disease, 90, 181-185. [Google Scholar] [CrossRef] [PubMed]
[31] Singh, C. and Roy-Chowdhuri, S. (2016) Quantitative Real-Time PCR: Recent Advances. In: Luthra, R., Singh, R.R. and Patel, K.P., Eds., Clinical Applications of PCR, Springer, 161-176. [Google Scholar] [CrossRef] [PubMed]
[32] Bhullar, S.S., Chandak, N.H., Purohit, H.J., Taori, G.M., Daginawala, H.F. and Kashyap, R.S. (2013) Determination of Viral Load by Quantitative Real-Time PCR in Herpes Simplex Encephalitis Patients. Intervirology, 57, 1-7. [Google Scholar] [CrossRef] [PubMed]
[33] Chen, Y.Y., Lin, J.W., Fan, Y.C. and Chiou, S.S. (2012) Detection and Differentiation of Genotype I and III Japanese Encephalitis Virus in Mosquitoes by Multiplex Reverse Transcriptase-Polymerase Chain Reaction. Transboundary and Emerging Diseases, 61, 37-43. [Google Scholar] [CrossRef] [PubMed]

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