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目的了解兰州地区2001年12月~2007年6月,人类轮状病毒(Human Rotavirus,HRV)毒株的流行特点及变异情况,为疫苗的研发提供流行病学资料。方法收集兰州大学第一医院2001年12月~2007年6月≤5岁住院腹泻患儿的粪便标本1305份,采用酶联免疫吸附试验检测HRV,抗原阳性标本采用逆转录-聚合酶链反应进行血清G和基因P分型。结果1305份粪便标本中,HRV抗原阳性662份(50.7%),其中G血清分型:G3型235份(35.5%),G1型206份(31.1%),G2型77份(11.6%),G9型14份(2.1%),G混合感染31份(4.7%),未分型99份(15.0%)。P基因分型508份,依次为P[8]型279份(54.9%),P[4]型73份(14.4%),混合5份(1.0%),P[6]型4份(0.8%),未分型147份(28.9%)。2001~2004年度(2001年12月~2002年6月为2001~2002年度;2002年7月~2007年6月,以前一年7月~翌年6月为一个年度,下同)以G3型为优势流行株;2004~2005年度主要流行株为G2型(34.4%),而2005~2007年度则以G1型为主要流行株。G血清型混合感染2001~2002年度占6.4%,2003~2004年度未检出,2004~2007年度分别占5.8%、3.2%、5.9%。检测结果显示,P基因型是以P[8]型为主,其中2001~2002年度、2003~2004年度分别占62.5%、33.3%,2004~2005年度则以P[4](45%)占主导地位,其次是P[8](22.1%),2005~2007年度分别占75.6%、68.4%。2001~2007年HRV感染G血清型和P基因型的组合以P[8]G1(43.9%)、P[8]G3(28.2%)、P[4]G2(12.8%)为主。HRV腹泻发病季节主要在9~12月。6~23月龄为高发年龄段,平均发病月龄为(10.8±6.9)月龄。结论HRV是兰州地区婴幼儿病毒性腹泻的最主要病原,临床症状重于非HRV腹泻,流行毒株变异多样,不同G血清型之间的混合感染比例高于国内其它地区,值得重视。
Objective To understand the prevalence and variation of human rotavirus (HRV) strain in Lanzhou from December 2001 to June 2007 and provide epidemiological data for the development of the vaccine. Methods A total of 1,305 stool samples from hospitalized children with diarrhea who were ≤5 years old were collected from the First Hospital of Lanzhou University from December 2001 to June 2007. The HRV was detected by enzyme-linked immunosorbent assay (ELISA). Positive antigen samples were detected by reverse transcription polymerase chain reaction Serum G and genotype P. Results Among 1305 stool specimens, 662 (50.7%) were positive for HRV antigen. Serum type G was 235 (35.5%) in G3, 206 (31.1%) in G1, 77 (11.6%) in G2, 14 (2.1%) G9 type, 31 (4.7%) G mixed infection and 99 (15.0%) non-typed. A total of 508 genotypes were genotyped, 279 (54.9%) of P [8], 73 (14.4%) of P [4], 5 %), No classification of 147 (28.9%). 2001-2004 (December 2001 ~ June 2002 for 2001 ~ 2002; July 2002 ~ 2007 June, the previous year in July to the following year in June as an annual, the same below) to type G3 Dominant epidemic strain. The main epidemic strain in 2004-2005 was G2 (34.4%), while G1 was the main epidemic strain in 2005-2007. G serotypes mixed infection accounted for 6.4% from 2001 to 2002, but not detected from 2003 to 2004, accounting for 5.8%, 3.2% and 5.9% respectively from 2004 to 2007. The results showed that the P genotype was predominantly P [8], of which 62.5% and 33.3% respectively from 2001 to 2002 and from 2003 to 2004 and P [4] (45%) from 2004 to 2005 Dominance, followed by P [8] (22.1%), accounting for 75.6% and 68.4% respectively from 2005 to 2007. The combination of G serotypes and P genotypes in HRV infection from 2001 to 2007 were mainly P [8] G1 (43.9%), P [8] G3 (28.2%) and P [4] G2 (12.8%). The incidence of HRV diarrhea season is mainly in September to December. 6 to 23 months of age as a high incidence of age, the average age of onset of (10.8 ± 6.9) months of age. Conclusions HRV is the most important pathogen of infantile viral diarrhea in Lanzhou. The clinical symptoms are more severe than those of non-HRV diarrhea. The variation of epidemic strains is diverse. The proportion of mixed infections among different G serotypes is higher than other regions of the country, which deserves attention.