2018年天津市儿童GⅡ型诺如病毒感染的分子流行病学分析  

Molecular epidemiology of pediatric Norovirus GⅡinfection in Tianjin,2018

作　　者：何菲 方玉莲[2] 林书祥[2] 侯梦珠 王维[2] 沈永明[3] 司萍[3] 彭林[4] He Fei;Fang Yulian;Lin Shuxiang;Hou Mengzhu;Wang Wei;Shen Yongming;Si Ping;Peng Lin(Clinical Laboratory,Tianjin Medical University Pediatric Clinical College,Tianjin Children′s Hospital,Tianjin 300070,China;Pediatric Research Institute,Tianjin Children′s Hospital,Tianjin 300134,China;Clinical Laboratory,Tianjin Children′s Hospital,Tianjin 300134,China;Tianjin Children′s Hospital,Tianjin 300134,China)

机构地区：[1]天津医科大学儿科临床学院天津市儿童医院检验科,天津300070 [2]天津市儿童医院儿科研究所,天津300134 [3]天津市儿童医院检验科,天津300134 [4]天津市儿童医院,天津300134

出　　处：《中华检验医学杂志》2020年第5期570-575,共6页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(81772259)。

摘　　要：目的分析2018年天津市儿童医院患儿GⅡ型诺如病毒(NoV)感染的分子流行病学特征。方法单中心研究。2018年1至12月就诊于天津市儿童医院疑似病毒感染引起急性胃肠炎患儿粪便标本2185份,采用实时荧光逆转录聚合酶链反应(RT-PCR)检测NoV,对阳性标本的衣壳蛋白VP1(VP1)区进行基因扩增并测序,分析基因型并运用MEGA5.05作系统进化树分析。结果2185份粪便标本中检出NoV阳性标本610份,阳性率为27.9%(610/2185),全部为GⅡ型,共发现7个基因型,以GⅡ.3型和GⅡ.4型为主,分别占46.2%(151/327)和40.1%(131/327),GⅡ.2型占4.6%(15/327),其他亚型占9.1%(30/327)。不同年龄组间NoV检出率差异有统计学意义(χ2=17.050,P=0.002),其中阳性标本中以≤3岁年龄组检出率最高,占阳性标本总数的89.2%,不同月份NoV检出率差异有统计学意义(χ2=225.153,P<0.001),其中11、12月为高发月份。GⅡ.3型和GⅡ.4型NoV感染的患儿在伴随粒细胞减少症方面,两种亚型差异有统计学意义(χ2=11.270,P=0.001),在伴随呼吸道症状方面,两种亚型差异有统计学意义(χ2=7.257,P=0.007)。结论2018年天津地区儿童NoV感染主要以GⅡ.3型和GⅡ.4型为主,基因型呈现多样性,提示本地区在今后应继续加强监测和预防儿童的NoV感染。Objective To analyze the molecular epidemiological characteristics of GⅡNorovirus(NoV)infection in children in Tianjin Children′s Hospital in 2018.Methods Single center study.From January to December 2018,a total of 2185 stool specimens were collected from the children with acute gastroenteritis suspected caused by virus infection in Tianjin Children′s Hospital.Norovirus was detected by real-time fluorescence reverse transcription polymerase chain reaction(RT-PCR).The capsid protein VP1(VP1)region of positive samples was amplified and sequenced.The phylogenetic tree was constructed by MEGA5.05 for analyzing the results.The detection of NoV in different age groups and different months were compared by SPSS 20.0.Results Among the 2185 stool specimens,610 were NoV positive,the positive rate was 27.9%(610/2185).All of the positive samples were GⅡgenogroup.Seven genotypes were found,with GⅡ.3 subtype accounting for 46.2%(151/327),GⅡ.4 subtype accounting for 40.1%(131/327),GⅡ.2 subtype accounting for 4.6%(15/327),other subtypes accounting for 9.1%(30/327).There was a significant difference in NoV detection rate among different age groups(χ2=17.050,P=0.002).Among the positive specimens,the detection rate of less than or equal to 3 years old was the highest which is accounting for 89.2%.Also there was a significant difference in NoV detection rate among different months(χ2=225.153,P<0.001).November and December are the most frequent months.There was significant difference between GⅡ.3 and GⅡ.4 NoV infection in children with granulocytopenia(χ2=11.270,P=0.001),and also in children with respiratory symptoms(χ2=7.257,P=0.007).Conclusions GⅡ.3 and GⅡ.4 were the main genotypes of NoV infection in children in Tianjin in 2018.The Multiple genotypes suggests that the monitoring and prevention of NoV infection in children should continue to be strengthened in the future.

关 键 词：诺罗病毒 胃肠炎 基因型 分子流行病学 儿童 

分 类 号：R725.1[医药卫生—儿科] R440[医药卫生—临床医学]