2016年浙江省急性胃肠炎患者诺如病毒的分子流行病学特征分析  

Molecular epidemiological analysis of norovirus in patients with acute gastroenteritis in Zhejiang province during 2016

作　　者：陈伟萍 崔大伟[1,2] 杨先知[1,2] 郑书发 谢国良[1,2] 陈瑜 CHEN Weiping;CUI Dawei;YANG Xianzhi;ZHENG Shufa;XIE Guoliang;CHEN Yu(Department of Laboratory Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang;Key Laboratory of Clinical in vitro Diagnostic Techniques of Zhejiang Province, Hangzhou 310003, Zhejiang;Genetic Laboratory of Shaoxing Women ＆ Children＇s Hospital, Shaoxing 312000, Zhejiang , China)

机构地区：[1]浙江大学医学院附属第一医院检验科,杭州310003 [2]浙江省临床体外诊断技术研究重点实验室,杭州310003 [3]绍兴市妇幼保健院遗传室,浙江绍兴312000

出　　处：《临床检验杂志》2018年第4期304-308,共5页Chinese Journal of Clinical Laboratory Science

基　　金：国家科技重大专项"传染病监测技术平台"项目(2012ZX10004-210)

摘　　要：目的探讨2016年浙江省急性胃肠炎患者中诺如病毒的流行病学和基因特征。方法收集2016年1月至12月共1 308份急性胃肠炎患者的临床流行病学资料和粪便标本,用一步法双重荧光RT-PCR技术检测诺如病毒GⅠ和GⅡ型,用分层抽样抽取阳性标本核酸进行普通RT-PCR扩增,并对扩增产物进行测序分析。结果诺如病毒阳性率为10.55%(138/1 308),其中GⅠ型12例,GⅡ型118例,GⅠ/GⅡ型混合感染8例。诺如病毒在不同年龄组的阳性率随患者年龄上升而下降,以≥60岁组最低;不同性别组间的阳性率差异无统计学意义;诺如病毒感染全年分布,其中12月阳性率达到顶峰,为37.50%。测序结果显示GⅠ的基因亚型主要是GⅠ.6;GⅡ的基因亚型以GⅡ.4与GⅡ.17为主,分别占40.91%(18/44)和34.09%(15/44)。结论诺如病毒是引起2016年浙江省急性胃肠炎的重要病原体,且GⅡ.4和GⅡ.17是主要的基因亚型。Objective To explore the molecular epidemiological characteristics of norovirus isolated from the patients with acute gastroenteritis in Zhejiang province during 2016. Methods The stool samples and clinical data of 1 308 patients with acute gastroenteritis were collected from January to December in 2016. The type Ⅰ and Ⅱ of norovirus in stool samples were detected by one-step double real-time RT-PCR. Some of the positive specimens were selected by stratified sampling and amplified by conventional RT-PCR, and the PCR products were sequenced for genotype identification and phylogenetic analysis. Results Among the samples studied the positive rate of norovirus was 10.55% （138/1 308）in which 12 cases were GI genotype, 118 cases were G Ⅱ genotype and 8 cases were mixed infection of G I/G Ⅱ genotypes. The positive rate of norovirus in different age groups decreased with the increased age of patients, and became the lowest in the patient group of more than or equal to 60 years old. There was no significant difference for the positive rates of norovirus in different genders. Norovirus infection was distributed throughout all the year with the peak value of positive rate （37.50%） in December. The sequence analysis demonstrated that G Ⅱ. 4 and G Ⅱ. 17 genotypes were the prevalent strains of G Ⅱ genotypes with proportions of 40.91% （18/44） and 34.09% (15/44) , while GL 6 genotype was the prevalent strain of GI genotypes. Conclusion Norovirus should be the important pathogen causing acute gastroenteritis in Zhejiang province during 2016. G Ⅱ.4 and G Ⅱ. 17 of norovirus may be the predominant epidemic genotypes.

关 键 词：诺如病毒 急性胃肠炎 基因型 

分 类 号：R446.5[医药卫生—诊断学]