2014年广州地区登革热患者病原学监测结果分析  

Analysis of etiological monitoring results of Dengue fever patients from Guangzhou in 2014

作　　者：罗招凡[1] 张凤宜 潘昆贻[1] 方伟祯[1] 庄豪[1] 赵文忠 任瑞文[3] 

机构地区：[1]中山大学孙逸仙纪念医院检验科,广东广州510120 [2]广东省计划生育专科医院优生科,广东广州510600 [3]广州军区疾病预防控制中心疾病监控科,广东广州510507

出　　处：《中华医院感染学杂志》2016年第20期4660-4663,共4页Chinese Journal of Nosocomiology

基　　金：全军医学科技"十二五"科研基金资助项目(CWS11C267);广州市科技计划基金资助项目(2014J4100003);广东省科技计划基金资助项目(2013B021800163)

摘　　要：目的分析广州地区登革病毒感染患者病原学特征,为登革热的预防控制工作提供病原学依据。方法采集2014年9月-12月医院就诊447例登革热疑似患者的急性期血清,应用实时荧光PCR检测登革病毒核酸RNA,采用ELISA检测登革病毒特异性抗原NS1,随机抽取部分病例进行核酸测序并利用生物信息学软件进行分析。结果共检测447例患者标本,其中357例登革病毒核酸阳性,阳性率79.87%;ELISA结果显示,NS1抗原阳性者350例,阳性率78.30%,登革病毒核酸RNA检出率高于NS1抗原,差异有统计学意义（P〈0.05）;成功测序登革病毒11株,BLAST分析表明均为登革1型病毒（DENV-1）,但序列之间存在差异,相似度为93.91%~100%.00。结论登革病毒核酸RNA是登革病毒感染早期诊断有效指标,对于尽快控制登革热疫情具有重要意义,2014年广州地区登革病毒存在基因变异,提示今后预防控制将面临更严峻的挑战。OBJECTIVE To analyze the etiological characteristics of Dengue fever patients from Guangzhou so as to provide pathogenic basis for the prevention and control of the disease. METHODS A total of 447 cases of specimens from acute patients of suspected Dengue fever from Sep. 2014 to Dec. 2014 were collected. Real-time fluorescence polymerase chain reaction （PCR） was adopted to detect the Dengue virus nucleic acid （RNA）, some of which were sequenced and performed with ClustalW software. ELISA was adopted to detect the specific NS1 Antigen for den- gue virus. RESULTS Totally 447 samples were involved in real-time PCR detection and 357 （79.87%） individuals showed positive results. ELISA results showed that the number of positive cases of NS1 was 350 （78.30M）. The detection rate of Dengue virus RNA was significantly higher than NS1 antigen （P〈0.05）. Totally 11 strains were sequenced successfully and confirmed as DENV-1 by BLAST search, and the sequences had a similarity of 93.91 ~100%. CONCLUSION The RNA by real-time PCR is more＇ valuable for early diagnosis of Dengue fever to pre- vent additional cases from dengue virus transmission, and the evolution of genetic complexity appears in the Guan- gzhou region in 2014, which makes the disease control face more serious challenge.

关 键 词：登革热 病原学 实时荧光PCR NS1抗原 

分 类 号：R181.23[医药卫生—流行病学]