河南省2017-2020年发热伴血小板减少综合征监测分析  

Surveillance for sever fever with thrombocytopenia syndrome in Henan province,2017-2020

作　　者：尤爱国[1] 李懿[1] 李东晓 杜燕华[1] 王海峰[1] 叶莹[1] 许汴利[1] 黄学勇[1] You Aiguo;Li Yi;Li Dongxiao;Du Yanhua;Wang Haifeng;Ye Ying;Xu Bianli;Huang Xueyong(Institute for Infectious Disease Control and Prevention,Henan Provincial Center for Disease Control and Prevention/Henan Key Laboratory of Pathogenic Organism of Infectious Diseases,Zhengzhou,450016,China)

机构地区：[1]河南省疾病预防控制中心传染病预防控制所/河南省传染病病原生物重点实验室,郑州450016

出　　处：《中华流行病学杂志》2021年第11期2024-2029,共6页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(81573204;81773500);河南省科技攻关(212102310613);河南省医学科技攻关计划(201702283);河南省中青年卫生健康科技创新领军人才培养项目(YXKC2020006)。

摘　　要：目的了解河南省2017-2020年发热伴血小板减少综合征(SFTS)监测病例的流行病学和病原学特征。方法利用描述流行病学方法对河南省2017-2020年SFTS病例特征进行分析。采集急性期病例血标本,应用实时荧光RT-PCR法检测新布尼亚病毒核酸。对部分分离到的病毒株扩增S片段基因,进行同源性分析,构建系统进化树。结果2017-2020年河南省共报告SFTS 1767例(疑似病例1000例、确诊病例767例),累计死亡11例(疑似病例3例、确诊病例8例),平均病死率为0.62%(11/1767);发病呈逐年下降趋势(趋势χ^(2)=12.018,P=0.001)。病例分布在6个城市28个县(区),信阳市报告1681例,占病例总数的95.13%(1681/1767)。病例主要发生在4-10月,占病例总数的96.10%(1698/1767)。男性发病率(0.38/10万)低于女性(0.54/10万)(χ^(2)=54.855,P<0.001);40~84岁占病例总数的93.44%(1651/1767);农民占病例总数的96.10%(1698/1767)。发生家庭聚集性疫情1起。共检测标本1110份,新布尼亚病毒的平均阳性率为39.19%(435/1110),不同年份的差异有统计学意义(χ^(2)=25.405,P<0.001)。分离到39株新布尼亚病毒中,S片段核苷酸同源性为94.76%~99.82%。39株病毒株完整S片段遗传进化分析结果显示,34株为A基因型、2株为B基因型,3株为D基因型。结论2017-2020年河南省SFTS以散发为主,发病呈逐年下降趋势,发病具有明显的地域性和季节性,发病范围不断扩大,女性、≥40岁和农民多发,不同年份新布尼亚病毒阳性率差异较大,新布尼亚病毒主要流行型别为A基因型,但仍需持续开展病原学监测。Objective To analyze the epidemiological and etiological characteristics of sever fever with thrombocytopenia syndrome(SFTS)cases in Henan province during 2017-2020.Methods Descriptive epidemiology method was used to analyze the characteristics of SFTS cases in Henan during 2017-2020.Patients'sera in acute phase were collected and tested using real-time fluorescence RT-PCR.The S segment complete sequences of the isolated sever fever with thrombocytopenia syndrome virus(SFTSV)strains were amplified and homology analysis was performed to construct the phylogenetic tree.Results A total of 1767 SFTS cases,including 1000 suspected cases and 767 confirmed cases,were reported in Henan during this period,and 11 cases,including 3 suspected cases and 8 confirmed cases died,the case fatality rate was 0.62%(11/1767).The incidence decreased year by year.The cases were distributed in 28 counties of 6 cities,and 1681 cases were reported in Xinyang,accounting for 95.13%(1681/1767)of the total.The cases mainly occurred from April to October,accounting for 96.10%(1698/1767)of the total.The incidence in males(0.38/100000)was significantly lower than that in females(0.54/100000)(χ^(2)=54.855,P<0.001).Up to 93.44%(1651/1767)of the cases were aged between 40 and 84 years.Farmers accounted for 96.10%(1698/1767)of the total cases.One family cluster outbreak occurred in 4 years.A total of 1110 samples were detected by Henan CDC,in which 435 were SFTS virus positive with an average positive rate of 39.19%(435/1110).The differences in positive rates of SFTS virus among different years were significant(χ^(2)=25.405,P<0.001).The sequence homology of complete S segment of the 39 SFTS virus strains ranged from 94.76% to 99.82%.The genetic evolution analysis on the complete S segment of the 39 SFTS virus strains showed that 34 strains belonged to genotype A,2 strains belonged to genotype B,and 3 strains belonged to genotype D.Conclusions The incidence of SFTS in Henan was sporadic,and decreased year by year.SFTS had obvious regional and seaso

关 键 词：发热伴血小板减少综合征 新布尼亚病毒 流行病学特征 监测 基因分型 

分 类 号：R512.8[医药卫生—内科学] R181.3[医药卫生—临床医学]