上海市长宁区2014—2015年急性结膜炎病原学鉴定与基因特征分析  

Pathological identification and gene characteristics analysis of acute hemorrhagic conjunctivitis in 2014-2015 in Changning District of Shanghai

作　　者：林征[1] 徐云蕴 黄峥[1] 

机构地区：[1]上海市长宁区疾病预防控制中心,上海200051 [2]上海市同仁医院,上海200051

出　　处：《上海预防医学》2017年第9期702-706,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市长宁区卫生计生系统医学特色专科项目(20163004;CNKW2013J09)

摘　　要：目的了解上海市长宁区急性结膜炎的病原学种类及流行病学特征。方法 2014年5月至2015年5月,在上海市长宁区监测点医院采集急性结膜炎患者眼拭子标本,抽提核酸后使用荧光RT-PCR法检测肠道病毒通用型、肠道病毒70型(EV70)、柯萨奇病毒A组24型(CA24v)及肠道腺病毒。选取腺病毒阳性标本采用普通PCR法进一步扩增腺病毒六邻体基因高变区片段。使用生物信息学软件对测序后序列信息进行研究以进一步确定感染腺病毒的基因型。结果检测的144份急性结膜炎患者标本中,22.22%(32/144)为肠道病毒通用型和腺病毒阳性,未检测到EV70和CA24v。腺病毒阳性共28份,占所有阳性标本的87.50%(28/32)。各年龄组腺病毒阳性率差异有统计学意义,20~39岁年龄组阳性率最高。对所有腺病毒阳性标本进行测序,共有5份标本测序成功,序列信息显示均为腺病毒D组,核酸序列同源性达到97.6%。结论 2014—2015年D组腺病毒是上海市长宁区急性结膜炎的最主要病原体,应在日后的监测中引起重视。Objective To ascetain the pathogen spectrum of acute hemorrhagic conjunctivitis and the epidemiologic characteristics in Changning District of Shanghai. Methods Conjunctival swabs were collected from outpatients with acute conjunctivitis from May 2014 to May 2015 at surveillance hospital in Shanghai Changning District. All Specimens were tested for universal enterovirus,enterovirus subtype 70,adenovirus and coxsackievirus A24,coxsackievirus A24 variant by real-time PCR or RT-PCR. PCR reactions were performed for amplification of partial adenovirus hexon genes. The evolution of amplified genes of selected adenovirus was analyzed by Lasergene and MEGA softwares. Results Of 144 samples of acute conjunctivitis,22. 22%（ 32/144） were universal enterovirus and adenovirus positive,without EV70 and CA24v detected. Adenovirus positiveness were found in 28 samples,accounting for 87. 50%（ 28/32）of all positive samples. The differences in the positive rates of adenovirus were statistically significant between different age groups,with the highest positive rate in the groups of age 20-39. After sequence analysis was done on all positive samples of adenovirus,it was proved that sequencing achieved success in5 samples. The sequence information was shown to be adenovirus group D; nucleic acid sequence homology reached 97. 6%. Conclusion The main pathogens of acute hemorrhagic conjunctivitis is adenovirus group D in 2014-2015 in Changning District of Shanghai,which should be given attention in future monitoring.

关 键 词：急性出血性结膜炎 腺病毒 肠道病毒 柯萨奇病毒 

分 类 号：R777.31[医药卫生—眼科]