人鼻病毒C组在上海三家医院儿童呼吸道感染的分子流行病学研究  

Study of the molecular epidemiology of human rhinovirus C in children with respiratory tract infection in three hospitals of Shanghai

作　　者：宋靖荣[1] 谢志萍[2] 高寒春[2] 林珍[1] 亢娟[1] 叶剑敏[3] 杨子珍[4] 段招军[2] 

机构地区：[1]上海交通大学医学院附属第三人民医院儿科,201900 [2]中国疾病预防控制中心病毒病预防控制所 [3]上海交通大学医学院附属新华医院小儿呼吸科 [4]上海市普陀区中心医院儿科

出　　处：《中华传染病杂志》2014年第12期729-734,共6页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金资助项目（81100005）

摘　　要：目的了解上海三家医院人鼻病毒（HRV）C组（HRV-C）在儿童急性呼吸道感染中的分子流行情况和临床特点。方法采用反转录聚合酶链反应（RT-PCR），对2012年1月至12月在上海交通大学医学院附属第三人民医院、上海交通大学医学院附属新华医院、上海市普陀区中心医院收集的271例急性呼吸道感染患儿的鼻咽抽吸物进行HRV-C基因检测、阳性产物测序、同源性和进化分析。计数资料采用卡方检验或核正卡方检验。结果271份标本中共检出HRV-C阳性扩增产物8份，检出率为3．0％，次于HRV—A（5．9％）；HRV-C核苷酸同源性为93％～100％，氨基酸同源性为97％～100％，其中5份存在混合感染，10月份检出较多，年龄均〈3岁，均诊断为下呼吸道感染，临床表现包括发热、阵发性咳嗽、咳痰、咽充血、肺部湿哕音、喘息等，无死亡病例。结论在上海三家医院急性呼吸道感染患儿中检出HRV-C，是次于HRV-A的流行基因型，其临床症状及诊断无特异性。Objective To investigate the molecular epidemiology and clinical characteristics of human rhinovirus （HRV）-C in children with acute respiratory tract infection in three hospitals of Shanghai, China. Methods Between January 2012 and December 2012, 271 nasopharyngeal aspiration （NPA） samples were collected from children who had been hospitalized for acute respiratory tract infection at Xinhua Hospital, Shanghai Jiaotong University School of Medicine, No. 3 People Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Putuo District Center Hospital, Shanghai. HRV-C was detected by the reverse transcription polymerase chain reaction （PCR） and all PCR positive products were sequenced. Phylogenetic analysis was performed. Enumeration data were analyzed using chi-square test. Results Eight out of 271 NPA samples were HRV-C positive, with the overall positive rate of 3.0%, ranking second to HRV-A（5.90/oo）. Partial sequencing of the genes coding shared a 93% to 100% nucleotide identity with the HRV-C reference strains, and the amino acid identity was 97% to 100~. Five of eight HRV-C positive samples were mix-infection. Positive specimens peaked in October. All HRV-C positive patients were ~ 3 years old, with clinical diagnosis of lower respiratory tract infection. The clinical manifestations of HRV-C positive children included fever, paroxysmal productive cough, sputum, pharynx congestion, moist rale and wheezing. No patient died. Conclusions HRV-C is an important cause of respiratory tract infections in children in Shanghai region, which is only next to HRV-A. The clinical manifestations and diagnosis are both not specific.

关 键 词：呼吸道感染 人鼻病毒 流行病学 儿童 

分 类 号：R725.6[医药卫生—儿科]