2019年辽宁省3例输入性三日疟基因型别实验室诊治与分析  

Laboratory Diagnosis,Treatment and Analysis of 3 Imported Quartqant Malaria Genotypes in Liaoning Province in 2019

作　　者：王博[1] 李鑫[1] 毛玲玲[1] 孙英伟[1] 王子江[1] 于维君[1] 姚文清[1] WANG Bo;LI Xin;MAO Ling-ling;SUN Ying-wei;WANG Zi-jiang;YU Wei-jun;YAO Wen-qing(Liaoning Prov.Ctr.for Disease Ctrl.&Prevent′n,Shenyang 110005)

机构地区：[1]辽宁省疾病预防控制中心,辽宁沈阳110005

出　　处：《微生物学杂志》2020年第6期84-90,共7页Journal of Microbiology

基　　金：国家科技重大专项(2017ZX10103007-001)。

摘　　要：对辽宁省2019年的3例境外输入性三日疟疟疾病例进行了实验室检测与诊断分析。收集并进行流行病学调查与资料汇总。根据疟疾实验室现有最新执行诊断标准《疟疾的诊断》(WS259-2015)的要求,对临床诊断的疑似三日疟患者采集抗凝血制作血涂片镜检、进行疟疾快速诊断检测(RDT),上送全血到辽宁省疾病预防控制中心进行病例复核,巢氏PCR检测并进行测序比对。3份病例患者外周血血涂片镜检薄厚血膜,虫体分期主要为环状体期、大滋养体期、配子体期和成熟裂殖体期,其中大滋养体期中疟色素呈深棕色、较大、沿边缘分布,发现寄生的红细胞通常不胀大甚至会缩小,配子体小而圆,根据镜下特点初步判定为三日疟原虫;RDT结果提示为感染除恶性疟以外的其他3种疟疾(三日疟、卵形疟、间日疟)的单一感染,省级参比实验室对于上送全血利用巢氏PCR检测技术进行复核检测;将扩增出的三日疟的目的片段产物序列送至上海维基基因测序公司进行序列分析比对,基因序列同源性达到了100%。同时使用血涂片镜检、进行疟疾快速诊断检测(RDT)和PCR进行检测,实验结果均鉴定为三日疟,根据病例的流行病学调查和临床表现确定为境外输入性三日疟病例。This study conducted laboratory testing and diagnostic analysis on 3 imported cases of quartant malaria from abroad in Liaoning Province in 2019.Collected and conducted epidemiological investigations and data gathering.According to the requirements of the latest diagnostic standard"Malaria Diagnosis"(WS259-2015)currently implemented by the malaria laboratory,the collection of anticoagulant blood for clinically diagnosed patients with suspected quartant malaria requires blood smear microscopy and rapid malaria diagnostic testing(RDT)and send whole blood to Liaoning Provincial Center for Disease Control and Prevention for case review,Nested PCR detection and sequencing comparison.The thin and thick blood film was microscopically examined by peripheral blood smears of 3 patients.The stages of the worms were mainly ring-shaped stage,macrotrophozoite stage,gametophyte stage and mature schizont stage.In the macrotrophozoic stage,malaria pigment was dark brown,larger,distributed along the edge,at the same time,it can be found that the parasitic red blood cells were usually not swollen or even reduced.The gametophyte was small and round.According to the characteristics of the microscope,it was preliminarily judged to be Plasmodium malariae.The RDT result indicated that the infection was not malignant.For single infections of three other malarias(quartant malaria,oval malaria,vivax malaria)except malaria,the provincial reference laboratory used Nested PCR detection technology to check the whole blood;The target fragment product sequence of the quartant malaria was sent to Shanghai Wikigene Sequencing Company for sequence analysis and comparison,and the gene sequence homology reached 100%.At the same time,blood smear microscopy,rapid malaria diagnostic test(RDT)and PCR were used for detection,and the experimental results were all identified as three quartant malaria cases.At the same time,according to the epidemiological investigation and clinical manifestations of the cases,they were identified as imported cases of three

关 键 词：输入性三日疟 镜检 快速诊断 巢氏多重PCR检测 

分 类 号：Q939.93[生物学—微生物学]