流行性乙型脑炎课件_18
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人与动物感染病毒后，不论发病或隐性
感染，血中均可产生补体结合抗体，中 和抗体及血凝抑制抗体. 有助临床诊断
和流行病学调查。
二、流行病学 Epidemiology
（一）传染源source of infection： 人畜共患的传染病， 人或动物受感染后出现病毒血症 是本病的传染源。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
三、发病机理
pathogenesis
乙脑病毒
人体 单核巨噬细胞繁殖
脑膜、脊髓病变 较轻、 脑实质、中脑、脑干重
病毒血症
脑水肿
机体抗力强
机体百度文库力弱
隐性感染 或轻型
病毒进入血脑屏障 中枢神经系统
脑疝 呼吸衰竭
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
病理：神经细胞变性、肿胀、坏死 1、血管：
血管内皮细胞肿胀、坏死、脱落、 扩张、充血，血管周围有淋巴细胞和单核 细胞浸润（血管套）
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
病毒对神经组织直接侵袭 神经细胞变性坏死，胶质细胞增生， 炎细胞浸润。 与免疫损伤有关。
病毒进入血脑屏障→特定部位→ 脑、→ 大脑
→
小脑→ 中脑桥脑→ 延髓
发生在分泌中枢→ 胃出血 拒食
体温调节中枢→ 体温↑
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
乙脑病人与隐性感染者为1：1000~2000， 感染后获得持久的免疫力。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
人
病 毒
蚊蚊 肠唾 道液
蚊 叮 咬
或 动 物
腺人被
感
染
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
人感染后病毒血症期短，（一般少于五日）且 血中病毒数量较少
乙脑病人和隐性感染者不是本病的主要传染源。 猪为100%感染（仔猪），在人流行前2周，
本病已在猪中广泛传播。 猪是最重要的传染源
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
（三）人群易感性susceptibility： 易感者 susceptible person 普遍易感，但感染后呈隐性感染较多。 感染后获得较持久的免疫力。 患病为10岁以下儿童多见。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
（四）流行病学特征epidemiologic feature：
22°C以上温度蚊虫活跃， 蚊虫繁殖适宜. 雨量多、蚊虫孳生密度大。 散发性、地域性，广州、海南多见。 北方地区为七、八、九三个月。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
流行性乙型脑炎
Epidemic encephalitis B
西安交通大学医学院
第一附属医院传染科
朱凤群
流行性乙型脑炎Epidemic encephalitis B
定义：简称乙脑，是由乙脑病毒 (Encephalitis B virus)引起的脑实质炎 症为主要病变，急性中枢神经系统传染病. 蚊虫传播，多发生于儿童，流行于夏秋季， 临床上以高热，意识障碍，抽搐，脑膜刺激征 为特征。重者常有脑水肿，脑疝，呼吸衰竭， 并可遗留神经系统后遗症。
疲劳，意外打击，淋雨等易患。 养峰人易感。 虫媒病毒300多种，20多种引起脑炎，53% 乙脑抗体Igm阳性。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
（二）传播途径route of transmission： 蚊虫是本病的主要传播媒介。 三带喙库蚊. 蚊虫通过蚊卵传代，是乙脑病毒的长期
储存宿主。 蚊虫吸血→蚊肠内增殖→唾液腺→叮咬
人 和动物→人和动物被感染。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
2、神经细胞： 变性和坏死. 在变性、坏死的神经细胞周
围常有胶质细胞围绕，小胶质细胞、中性粒细胞 侵入神经细胞内，形成噬神经现象。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
发病季节
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
常用消毒剂均能灭活，如酒精、石碳酸 等。
病毒能在乳鼠脑组织中传代，抗原性较 稳定。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
近年儿童和青少年广泛接种乙脑疫苗，成 人 和老年人的发病率相对较高。
小儿易患是血脑屏障不建全， 血脑屏障受了破坏，患囊虫病的病人易感。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
一、病原学Etiology
虫媒病毒arborvirus，根据其形态结构 属于披盖病毒，呈球形，直径15~22nm，核 糖核酸病毒，表面具有含有血凝集棘突，能凝 集雏鸡、鸽、鹅红细胞，病毒抵抗力不强。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
感染，血中均可产生补体结合抗体，中 和抗体及血凝抑制抗体. 有助临床诊断
和流行病学调查。
二、流行病学 Epidemiology
（一）传染源source of infection： 人畜共患的传染病， 人或动物受感染后出现病毒血症 是本病的传染源。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
三、发病机理
pathogenesis
乙脑病毒
人体 单核巨噬细胞繁殖
脑膜、脊髓病变 较轻、 脑实质、中脑、脑干重
病毒血症
脑水肿
机体抗力强
机体百度文库力弱
隐性感染 或轻型
病毒进入血脑屏障 中枢神经系统
脑疝 呼吸衰竭
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
病理：神经细胞变性、肿胀、坏死 1、血管：
血管内皮细胞肿胀、坏死、脱落、 扩张、充血，血管周围有淋巴细胞和单核 细胞浸润（血管套）
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
病毒对神经组织直接侵袭 神经细胞变性坏死，胶质细胞增生， 炎细胞浸润。 与免疫损伤有关。
病毒进入血脑屏障→特定部位→ 脑、→ 大脑
→
小脑→ 中脑桥脑→ 延髓
发生在分泌中枢→ 胃出血 拒食
体温调节中枢→ 体温↑
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
乙脑病人与隐性感染者为1：1000~2000， 感染后获得持久的免疫力。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
人
病 毒
蚊蚊 肠唾 道液
蚊 叮 咬
或 动 物
腺人被
感
染
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
人感染后病毒血症期短，（一般少于五日）且 血中病毒数量较少
乙脑病人和隐性感染者不是本病的主要传染源。 猪为100%感染（仔猪），在人流行前2周，
本病已在猪中广泛传播。 猪是最重要的传染源
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
（三）人群易感性susceptibility： 易感者 susceptible person 普遍易感，但感染后呈隐性感染较多。 感染后获得较持久的免疫力。 患病为10岁以下儿童多见。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
（四）流行病学特征epidemiologic feature：
22°C以上温度蚊虫活跃， 蚊虫繁殖适宜. 雨量多、蚊虫孳生密度大。 散发性、地域性，广州、海南多见。 北方地区为七、八、九三个月。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
流行性乙型脑炎
Epidemic encephalitis B
西安交通大学医学院
第一附属医院传染科
朱凤群
流行性乙型脑炎Epidemic encephalitis B
定义：简称乙脑，是由乙脑病毒 (Encephalitis B virus)引起的脑实质炎 症为主要病变，急性中枢神经系统传染病. 蚊虫传播，多发生于儿童，流行于夏秋季， 临床上以高热，意识障碍，抽搐，脑膜刺激征 为特征。重者常有脑水肿，脑疝，呼吸衰竭， 并可遗留神经系统后遗症。
疲劳，意外打击，淋雨等易患。 养峰人易感。 虫媒病毒300多种，20多种引起脑炎，53% 乙脑抗体Igm阳性。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
（二）传播途径route of transmission： 蚊虫是本病的主要传播媒介。 三带喙库蚊. 蚊虫通过蚊卵传代，是乙脑病毒的长期
储存宿主。 蚊虫吸血→蚊肠内增殖→唾液腺→叮咬
人 和动物→人和动物被感染。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
2、神经细胞： 变性和坏死. 在变性、坏死的神经细胞周
围常有胶质细胞围绕，小胶质细胞、中性粒细胞 侵入神经细胞内，形成噬神经现象。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
发病季节
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
常用消毒剂均能灭活，如酒精、石碳酸 等。
病毒能在乳鼠脑组织中传代，抗原性较 稳定。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
近年儿童和青少年广泛接种乙脑疫苗，成 人 和老年人的发病率相对较高。
小儿易患是血脑屏障不建全， 血脑屏障受了破坏，患囊虫病的病人易感。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians
一、病原学Etiology
虫媒病毒arborvirus，根据其形态结构 属于披盖病毒，呈球形，直径15~22nm，核 糖核酸病毒，表面具有含有血凝集棘突，能凝 集雏鸡、鸽、鹅红细胞，病毒抵抗力不强。
do we simplify complex fractions and complex rational Disorders Building a Community of Support Immunizations American Acade my of Family Phy sicians