不同基因型新型冠状病毒感染病例的特征分析  

Characteristics of cases infected by severe acute respiratory syndrome coronavirus 2 of different genotypes

作　　者：李娇 毛毅 陈恒 杨铭[4] 张仁卿 蒋良双 蒲萍 刘良茜 肖艳 王营 党盛源 任丽丽 LI Jiao;MAO Yi;CHEN Heng;YANG Ming;ZHANG Renqing;JIANG Liangshuang;PU Ping;LIU Liangqian;XIAO Yan;WANG Ying;DANG Shengyuan;REN Lili(Emergency Department,Chengdu Public Health Clinical Medical Center,Chengdu,Sichuan 610061,P.R.China;Chengdu Workstation of Emerging Infectious Diseases,Chinese Academy of Medical Sciences,Chengdu,Sichuan 610041,P.R.China;Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610041,P.R.China;Tuberculosis Department,Chengdu Public Health Clinical Medical Center,Chengdu,Sichuan 610061,P.R.China;National Health Commission of the People’s Republic of China Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory,Institute of Pathogen Biology,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,P.R.China;Key Laboratory of Respiratory Disease Pathogenomics,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,P.R.China)

机构地区：[1]成都市公共卫生临床医疗中心应急科,成都610061 [2]中国医学科学院成都新发突发传染病防治工作站,成都610041 [3]成都市疾病预防控制中心,成都610041 [4]成都市公共卫生临床医疗中心结核科,成都610061 [5]中国医学科学院病原生物学研究所国家卫生健康委病原系统生物学重点实验室/克里斯托弗·梅里埃实验室,北京100730 [6]中国医学科学院呼吸道疾病病原组研究重点实验室,北京100730

出　　处：《华西医学》2022年第2期171-175,共5页West China Medical Journal

基　　金：四川省科技计划项目(2021YFS001);中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2020-PT330-005)。

摘　　要：目的探讨不同基因型新型冠状病毒感染者的临床特征的差异。方法采用回顾性研究方法,选取2020年1月-9月成都市公共卫生临床医疗中心收治的111例境内外新型冠状病毒感染者为研究对象,收集感染者的基本资料、基因测序结果(Pangolin分型法)、临床分型、入院24 h首次实验室检查、是否复阳等情况。根据Pangolin分型法将感染者分为A型、B型、B.X型、B.1.X型和B.1.1.X型,对比5种基因型感染者的基本情况(年龄、性别、来源地)、临床分型、实验室检查结果(淋巴细胞计数、C反应蛋白、血清淀粉样蛋白A、CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞)及是否复阳。结果111例感染者中,男54例(48.6%),女57例(51.4%);年龄16~87岁,中位年龄49岁;临床分型:无症状感染者10例(9.0%),轻型10例(9.0%),普通型64例(57.7%),重型13例(11.7%),危重型14例(12.6%);境内病例75例(67.6%),境外输入病例36例(32.4%);未复阳80例(72.1%),复阳31例(27.9%);基因型A型8例,B型18例,B.X型26例,B.1.X型5例,B.1.1.X型54例。不同基因型新型冠状病毒感染者的性别、年龄、临床分型、实验室检查结果和是否复阳差异均无统计学意义(P>0.05),境内外病例分布差异有统计学意义(P=0.016),B型多为本土病例,B.X型多为境外输入病例。结论不同基因型新冠病毒感染者的境内外病例分布存在差异。Objective To explore the clinical characteristics of patients who were infected by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)of different genotypes.Methods A retrospective study was conducted on 111 SARS-CoV-2 infected cases at home and abroad admitted to Chengdu Public Health Clinical Medical Center between January and September 2020.The basic information,gene sequencing results(Pangolin typing method),clinical typing,first laboratory examinations 24 hours after admission,and whether repositive after discharge were collected.According to Pangolin typing,patients were divided into five groups:A,B,B.X,B.1.X and B.1.1.X.The basic information(age,sex,and origin),laboratory test results(lymphocyte count,C-reactive protein,serum amyloid A,CD3^(+)T lymphocytes,CD4^(+)T lymphocytes,and CD8^(+)T lymphocytes),clinical classification and whether repositive were compared among different genotype infected patients.Results Among the 111 infected patients,54(48.6%)were males and 57(51.4%)were females.Their ages ranged from 16 to 87 years,with a median age of 49 years.In terms of clinical classification,there were 10 asymptomatic cases(9.0%),10 mild cases(9.0%),64 ordinary cases(57.7%),13 severe cases(11.7%),and 14 critical cases(12.6%).There were 75 domestic cases(67.6%)and 36 imported cases(32.4%).Eighty cases(72.1%)did not return to positive,and 31 cases(27.9%)returned to positive.There were 8 cases infected by type A virus,18 cases infected by type B virus,26 cases infected by type B.X virus,5 cases infected by type B.1.X virus,and 54 cases infected by type B.1.1.X virus.Among patients infected by different genotype viruses,no statistically significant difference was found in sex,age,clinical type,laboratory examination,or whether repositive(P>0.05),but there was statistically significant difference in the distribution of domestic and imported cases(P=0.016).Type B virus infected patients were mostly domestic cases,while type B.X virus infected patients were mostly imported cases.Conclusion The distribution

关 键 词：新型冠状病毒 基因型 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]