人类偏肺病毒与呼吸道合胞病毒呼吸道感染的临床研究  

A clinical study on the respiratory tract infections with human metapneumovirus and respiratory syncytial virus

作　　者：苏跃青[1] 伍严安[2] 陈发林[2] 黄肖莉[2] 吴小青[1] 曾秀雅[1] 

机构地区：[1]福建省妇幼保健院新生儿疾病筛查中心,福州350001 [2]福建医科大学省立临床学院福建省立医院检验科

出　　处：《中华传染病杂志》2010年第6期343-347,共5页Chinese Journal of Infectious Diseases

基　　金：福建省自然科学基金资助项目（F0310042）

摘　　要：目的 了解福州地区人类偏肺病毒（HMPV）感染情况,比较HMPV与呼吸道合胞病毒（RSV）引起呼吸道感染的临床特征及流行特点.方法 采集2005年至2007年连续两个冬春季节153份福建省立医院就诊呼吸道感染患者痰标本或咽拭子标本,RT-PCR和套式RT-PCR分别检测RSV和HMPV,部分阳性PCR产物测序,DNAMAN软件分析;结合临床资料,比较两种病毒所引起的呼吸道感染临床症状、体征和流行特点.结果 153份鼻咽分泌物标本中,32份HMPV阳性,阳性率为20.9%;26份RSV阳性,阳性率为17.0%,8份HMPV和RSV均阳性.随机抽取3份标本,HMPV核苷酸序列一致,登载NCBI基因库（序列号DQ887758）,基因进化树分析为单一基因型,属A基因型,但发生部分变异.2005年至2006年冬春HMPV阳性26份,阳性率为26.7%,2006年至2007年冬春HMPV阳性6份,阳性率为10.7%,而RSV检出情况与HMPV相反.儿童RSV感染平均年龄为（2.65±2.65）岁,HMPV为（4.58±3.35）岁.两种病毒引起呼吸道感染症状均以咳嗽、咽痛,发热为主.结论 HMPV与RSV均是福州地区冬春季节呼吸道病毒感染的主要病原体,两者可合并感染;HMPV主要感染年龄较大儿童,HMPV与RSV的临床特征相似.本研究期间福州地区发现的HMPV为单一基因型.Objective To investigate the prevalence of human metapneumovirus （HMPV）infection in patients with respiratory infection in Fuzhou area and compare their epidemic features and clinical characteristics with those of infected with respiratory syncytial virus （RSV）. Methods A total of 153 sputum or pharyngeal swab samples from patients with respiratory tract infection were collected in Fujian Provincial Hospital in consecutive winter and spring seasons from 2005 to 2007. HMPV was detected by nested reverse transcriptase-polymerase chain reaction （RT-PCR） and RSV was tested by RT-PCR. Parts of PCR products were sequenced and analyzed using DNAMAN software. The clinical symptoms, signs and epidemiology of the respiratory tract infections caused by HMPV and RSV were compared. Results In the 153 specimens, 32 （20.9%） were positive for H MPV, 26 （17.0%） were positive for RSV, and 8 were both HMPV and RSV positive. Nucleotide sequences of three 432-bp PCR products were 100% identical and submitted to GenBank （the accession No. DQ887758）.Phylogenetic tree analysis of nucleotide sequences revealed that the three isolates clustered in HMPV belonged to genotype A with part of mutation. Twenty-six samples （26. 7%） were HMPV positive from Dec 2005 to Apr 2006 and 6 （10.7%） were positive from Dec 2006 to Apr 2007. The RSV detection rate was opposite of HMPV. The mean age of RSV infection in children was （2.65±2.65）years old and HMPV infection was （4.58 ±3.35） years old. The main clinical manifestations of both RSV and HMPV infections were cough, sore throat and fever. Conclusions Both HMPV and RSV are the major pathogens of respiratory tract infection in Fuzhou area and HMPV and RSV coinfection could be detected. HMPV infected children are older. The clinical features of HMPV and RSV infections are similar. Single genotype of HMPV is detected in Fuzhou area in this study.

关 键 词：呼吸道感染 肺类病毒属 呼吸道合胞体病毒 人 反转录聚合酶链反应 基因型 

分 类 号：R5[医药卫生—内科学]