深圳市南山区腹泻患儿诺如病毒筛查及其基因分型研究  

Norovirus screening and genotyping analysis among infants with diarrhea in Nanshan district of Shenzhen city

作　　者：徐丹[1] 甘萍[1] 蒋莉[1] 张丽芬[1] 黎绍昌[1] 

机构地区：[1]广东医学院附属深圳市南山区人民医院检验科,广东深圳518052

出　　处：《国际检验医学杂志》2014年第6期663-666,共4页International Journal of Laboratory Medicine

基　　金：深圳市科技计划项目(201203222)

摘　　要：目的：了解秋冬季深圳市南山区门诊5岁以下儿童病毒性腹泻散发病例中诺如病毒感染状况及基因型别。方法收集深圳市南山区2010～2013秋冬季年深圳市南山区人民医院门诊临床诊断为病毒性腹泻的患儿临床资料及粪便标本748份，采用多重聚合酶链反应方法检测轮状病毒、诺如病毒、星状病毒、肠道腺病毒，将诺如病毒抗原阳性的标本用逆转录-聚合酶链反应方法进行轮状病毒核酸扩增，将阳性产物回收、纯化并测序。结果748份标本中，共检出384例至少感染1种腹泻病毒，总检出率为51．33％（348/748），其中301例感染1种腹泻病毒，47例为2种以上腹泻病毒混合感染。诺如病毒感染性腹泻发病高峰季节在10～11月份，占65．6％（82/125）。诺如病毒感染年龄在2岁以下的，占95．20％（119/125），7～12个月的婴幼儿感染率，占68．8％（86/125），与1～6个月的婴幼儿感染率比较差异有统计学意义（P＜0．05）。诺如病毒混合感染率为11．20％（14/125）与肠道腺病毒混合感染率比较差异有统计学意义（P＜0．05）。男性感染率为45．6％（57/125），女性感染率为54．4％（68/125），两者比较差异无统计学意义（P＞0．05）。诺如病毒基因分析显示，测序的114株均属于 GⅡ-4型，不同毒株间核酸序列同源性为98％～100％。结论诺如病毒是深圳市南山区7～12个月婴幼儿病毒性腹泻的主要病原体，感染较易发生在10、11月份。GⅡ-4型是深圳市南山区婴幼儿诺如病毒感染性腹泻的主要基因型。Objective To investigate the infection status and genotype of norovirus in sporadic cases of viral diarrhea among out-patient children under 5 years in autumn and winter in Nanshan district of Shenzhen city. Methods 748 stool specimens were col-lected from infants and children under 5 years old with acute non-bacterial diarrhea in the Nanshan District People＇s Hospital in au-tumn and winter from 2010 to 2013. Multiplex RT-PCR was used to detect rotavirus （RV）, norovirus （NV）, astrovirus （AstV） and enteric adenovirus. The specimens with positive NV antigen were performed the RV nucleic acid amplification by the RT-PCR method and the positive products were recovered,purified and sequenced. Results Among 748 specimens,384 cases were identified for at least one viral＇ infection with the detection rate of 51.33 % （384/748）, of which 301 cases were single virus infection and 47 ca-ses were mixed infection of more than 2 kinds of diarrhea virus. The peak of NV infection was between October to November, ac-counting for 65.6%（82/125）,children aged below 2 years old with NV infection accounted for 95.20%（119/125）. The infection rate in infants aged 7-12 months accounted for 68.8~ （86/125）, compared with the infants aged 1-6 months, the difference be-tween them were statistically significant （P〈0.05）. The NV mixed infection rate was 11.20 % （ 14/125 ）. The male infection rate was 45.6 %（57/125） and the female infection rate was 54.4 %（68/125）, the difference between them had no statistical significance （P〉0.05）. The NV gene analysis indicated that 114 sequenced strains belonged to type G Ⅱ-4, the homology of nucleic acid se- quence in different strains was 98% to 100%. Conclusion NV is the main pathogen of viral diarrhea in 7-12 months infants in Nanshan district of Shenzhen city. Norovirus infection is prone to in October and November. The type G Ⅱ-4 is the predominant genotype in infantile diarrhea of NV in Nanshan district.

关 键 词：轮状病毒属 基因型 腹泻 病毒性疾病 

分 类 号：R725.1[医药卫生—儿科]