2001～2007年兰州急性腹泻住院儿童轮状病毒感染的临床特点及分子流行病学研究  

Study on the Clinical Characteristic and Molecular Epidemiology of Children Hospitalized with Acute Diarrhea by Rotavirus Infection in Lanzhou City in 2001～2007

作　　者：叶新华[1] 金玉[1] 方肇寅[2] 段招军[2] 李宇宁[1] 杨学梅[1] 程卫霞[1] 董巧丽[1] 黄湘[1] 

机构地区：[1]兰州大学第一医院,甘肃兰州730000 [2]中国疾病预防控制中心病毒病预防控制所,北京100052

出　　处：《中国疫苗和免疫》2008年第5期452-457,共6页Chinese Journal of Vaccines and Immunization

基　　金：国家自然科学基金(30270069);世界卫生组织基金(V27/181/123);美国适宜卫生科技组织基金资助项目(GAV.1142.01-07228-LPS);甘肃省科技攻关资助项目(2GSO54-A43-014-27)

摘　　要：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 Rotavirus strain epidemic and the variation in Lanzhou Gansu province of China from Dec 2001 to June 2007,and to provide epidemiological data for developing rotavirus vaccine.Methods Enrolled in-patients who were younger than 5 years old with acute diarrhea and admitted to the First Hospital of Lanzhou University from 2001 to 2007.Stool specimens were collected.Dako IDEIATM kits were used for the detection of rotavirus.Serotyping G and genotyping P identifications of the rotavirus were determined by RT-PCR.Results Of the total 1305 stool specimens,the rotavirus was present in 50.7%（662）of them.G serotyping as G3 was 235（35.5%）,G2 77（11.6%）,G1 206（31.1%）and G9 14（2.1%）.There were mixed-G infection 31（4.7%）and non-typeable 99（15.0%）.Of the 508 P genotyping,in turn,P[8]accounted for 279（54.9%）,P73（14.4%）,P[6]4（0.8%）,there were 5（1.0%）mixed-P infection,and 147（28.9%）non-typeable.G3 was the most prevalent G type found in this study from Dec 2001 to Jun 2004.G2 was the most prevalent G type（34.4%）from Jul 2004 to Jun 2005,but G1（61.4%）was the most prevalent strain from Jul 2005 to Jun 2007.P[8]was the most prevalent P genotype found in the 6 consecution years study.But there was a large change of P type from 2004 to 2005,P[4]（45%）was the predominant P type,followed by P[8]（22.1%）.The predominant G-P combination was P[8]G1（43.9%）,followed by P[8]G3（28.2%）and PG2（12.8%）.Rotavirus diarrhea admissions peaked between september and december.Continuous surveillance showed that incidence rates of rotavirus were the highest among the infants aged 6～23 months,average was 10.8±6.9 months.Conclusion Rotavirus still remained the most important viral agent causing diarrhea hospitalizations among children under 5 years old in Lanzhou of China.The clinic symptoms were more severe than that of non-HRV.There was shifting of predominant strain differed by year.Mixed-G infection percentage in Lanzhou was higher than that of other are

关 键 词：人类轮状病毒 腹泻 临床特点 分子流行病学 

分 类 号：R373.2[医药卫生—病原生物学]