河南地区5岁以下病毒性腹泻患儿流行特征及病原学监测  

Epidemiological characteristics and etiological surveillance of virus diarrheal among children under 5 years old, Henan Province

作　　者：王跃生[1] 张敬[1] 李小芹[1] 于静[1] 周方[1] 

机构地区：[1]郑州市儿童医院消化内科,河南郑州450000

出　　处：《现代预防医学》2015年第23期4290-4293,共4页Modern Preventive Medicine

摘　　要：目的 分析2011-2014年河南地区5岁以下婴幼儿病毒性腹泻感染状况、季节流行特征及轮状病毒（HRV）血清型基因分型。方法 收集2011年12月-2014年12月单中心郑州市儿童医院住院腹泻患儿粪便共506份。由中国疾病预防控制中心检测轮状病毒（HRV）,人星状病毒（HAst V）、人杯状病毒（Hu CV）、肠道腺病毒（EAd V）及轮状病毒阳性标本血清型基因分型检测。结果 检测的506份标本中HRV（224）44.26%、HAst V（83）16.40%、Hu CV（诺如病毒II型为主）（58）11.46%、EAd V（32）6.32%、未定型（109）21.54%,HRV是导致河南地区婴幼儿病毒性腹泻的主要病原;每年秋冬季节患儿病毒阳性率检出明显升高;病毒性腹泻各组间所占比例在男女性别上无显著差异;腹泻患儿发病的高峰年龄为6~24月龄,占51.54%（183/355）;224份RV检测阳性标本G血清型和P基因型分布特征,G血清型流行优势毒株为G3型90份（40.17%）,未发现G8型。P基因型分型结果显示,最常见的毒株是P8型99份（44.19%）。基因型组合：以G3P[8]为主;506份检测标本中混合感染共24份（4.74%）,以轮状病毒混合其他病毒感染为主,占50%（12/24）,轮状病毒和人星状病毒混合感染最多,占29.16%（7/24）;其次,轮状病毒和人杯状病毒混合感染占20.83%（5/24）。混合感染的患儿中〈2岁的占83.33%（20/24）。结论 河南地区5岁以下儿童病毒性腹泻的病原分型复杂,以轮状病毒检出率高,发病高峰在每年秋冬季节,以6~24月龄婴幼儿为主,HRV主要亚型G3[P8],同时存在不同病原混合感染的现象,具有明显的季节差异和人群分布。Objective To investigate the infection condition and epidemic characteristics of virus diarrheal and genotyping of rotavirus among children under 5 years old in Henan Province. Methods 506 cases of stool specimens were collected from inpatients with acute diarrhea at Children＇s hospital of Zhengzhou, from December 2011 to 2014. Enzyme-linked immunosorbant assay （ELISA） and Reverse transeription-polymerase chain reaction （RT-PCR） were used to detected rotavirus, human caliciruses, astrovirus, enteric adenovirus and genotyping of rotavirus in CCDC. Results RV, HAstV, HuCV （The main Norovirus II） and EAdV were identified in 44.26% （224）, 16.40% （83）, 11.46% （58）, 6.32% （32） in 506 specimens respectively. 109 （21.54%） cases were undefined. HRV was the major pathogen contributing to the acute virus diarrhea in Henan province. The positive rate of virus detection was significantly increased in autumn and winter. Viral diarrhea among groups had no significant difference in the proportion of male and female; the highest infection rates of diarrhea were 51.54% （183/355）, in 6-24 months old children. G serum type and the distribution of P genotype were tested in the 224 HRV positive specimens. HRV G3 （40.17%） was the most prevailing serotype, G8 was not found. P[8] （44.19%） was the most common strain in P genotyping. The most common G-P genotype combinations was G3P[8].Twenty-four （4.74%） of 506 samples were found positive to more than one viral agent, the main was mixed HRV and other virus, accounting for 50% （12/24）, in which 7 samples contained both HRV and HAstV, and 5 samples contained both HRV and HuCV, the mixed infection was 83.33% （20/24） diarrheal under 2 years of age. Conclusion The viral diarrhea pathogen type is complex among children under 5 years old in Henan Province. The major pathogen was HRV in autumn and winter. Children in 6 - 24 months old are at high level of infection, and G3[P8] is the most prevailing serotype. Mixed infections with obvious

关 键 词：病毒性腹泻 轮状病毒 人杯状病毒 肠道腺病毒 人星状病毒 

分 类 号：R179[医药卫生—妇幼卫生保健]