2017-2021年北京市20岁以下带状疱疹病原特点和临床特征分析  

Analysis of the etiological features and clinical characteristics of herpes zoster cases under 20 years old in Beijing City from 2017 to 2021

作　　者：潘静彬[1] 周涛[1] 索罗丹[1] 袁力勇 权娅茹 王海红[3] 彭兴慧 王涛[3] 朱宗龙[3] 王砚飞 赵丹[1] 卢莉[1] Pan Jingbin;Zhou Tao;Suo Luodan;Yuan Liyong;Quan Yaru;Wang Haihong;Peng Xinghui;Wang Tao;Zhu Zonglong;Wang Yanfei;Zhao Dan;Lu Li(Institute for Immunization and Prevention,Beijing Center for Disease Control and Prevention,Beijing 100013,China;Institutes for Biological Products Control,National Institutes for Food and Drug Control,Beijing 102629,China;Department of Expanded Program on Immunization,Changping District Center for Disease Control and Prevention,Beijing 102200,China;Department of Expanded Program on Immunization,Miyun District Center for Disease Control and Prevention,Beijing 101500,China)

机构地区：[1]北京市疾病预防控制中心免疫预防所,北京100013 [2]中国食品药品检定研究院生物制品检定所,北京102629 [3]北京市昌平区疾病预防控制中心计划免疫科,北京102200 [4]北京市密云区疾病预防控制中心计划免疫科,北京101500

出　　处：《中华预防医学杂志》2024年第3期285-291,共7页Chinese Journal of Preventive Medicine

摘　　要：目的:分析2017-2021年北京市20岁以下带状疱疹病毒(VZV)感染病例病原特点和临床特征。方法:带状疱疹病例来源于2017年12月至2021年4月北京市带状疱疹监测系统,包括两个哨点区(密云区和昌平区)7家哨点医院的20岁及以下带状疱疹病例。首次就诊时收集病例基本信息,并采集病原学标本,调查其出疹日期、疱疹部位、疱疹数量等;出疹21 d时通过电话随访调查疼痛程度、疱疹持续时间、疼痛持续时间等临床特征;出疹90 d时对出疹21 d随访仍有神经痛者再次调查其疼痛情况判断是否发生带状疱疹后神经痛。提取疱疹液中的病毒DNA后对其ORF62基因区域进行PCR扩增和一代测序获取病毒序列,通过序列比对鉴定野毒株/疫苗株,并比较不同水痘疫苗接种史病例的临床特征。结果:2017-2021年北京市20岁及以下带状疱疹病例共计78例,其中61例病例完成随访调查。61例病例的年龄范围为1.83~20.54岁,年龄 M为17.50岁;男性36例(59.02%),女性25例(40.98%);有水痘接种史者29例(1、2剂次接种史者分别为18、5例,剂次不详者6例),无水痘疫苗接种史的13例,接种史不详者19例。78例病例中VZV核酸阳性者64例,其中62例鉴定结果为野毒株,2例为疫苗株;2例疫苗株病例均为2岁女童,均有1剂水痘疫苗接种史,分别于接种疫苗后3个月和13个月后发病。29例有水痘疫苗接种史的带状疱疹病例的疱疹数量以10~49个为主,占58.62%(17例);疱疹部位以躯干为主,占44.83%(13例);疼痛程度“无或轻度”占比51.72%(15例);带状疱疹病例最痛评分、疼痛持续时间、疱疹完全结痂时间的 M( Q1, Q3)分别为3(1.5,5)分、10(1.5,12.5)d、10(6.5,13)d,均未发生带状疱疹后神经痛。有接种史、无接种史和接种史不详者疱疹个数、疱疹部位及疼痛程度的构成比差异没有统计学意义(均 P>0.05),其疼痛持续时间、最痛评分和疱疹结痂时间差异也没有统计学意义(均 P>Objective To analyze the etiological features and clinical characteristics of herpes zoster cases under 20 years old in Beijing City from 2017 to 2021.Methods Herpes zoster cases were collected from a surveillance system in Beijing City from December 2017 to April 2021.The cases included individuals under 20 years old from seven sentinel hospitals located in two districts(Miyun District and Changping District).The basic information,the rash date of rash onset and the location and number of lesions were investigated at the first visit to the hospital,and the lesion swab samples were collected for laboratory testing.A telephone follow-up was conducted 21 days after the onset of the rash to investigate the degree of pain,duration of the rash and duration of pain.The individuals who still experienced neuralgia were further investigated for their pain condition at 90 days after the onset of the rash,to discover cases with postherpetic neuralgia.DNA was extracted from the rash fluid,and the ORF62 gene region was amplified and sequenced to obtain the viral sequence.The wild-type strain or chickenpox vaccine strain was identified by using sequence alignment,and the clinical characteristics of cases with different varicella vaccinations were compared.Results A total of 78 herpes zoster cases under 20 years old were investigated during 2017-2021 in Beijing City,and 61 cases completed the follow-up survey.The age range of 61 cases was 1.83 to 20.54 years with a median age of 17.50 years.There were 36 males(59.02%)and 25 females(40.98%).Among them,there were 29 cases with the chickenpox vaccine immunization history(18 cases with one dose,5 cases with two doses and 6 cases with unknown doses),13 cases with no vaccination history and 19 cases with unknown vaccination history.Among the 78 cases,the herpetic fluid samples of 64 cases were positive for VzV,including 62 cases identified as wild-type strains and two cases as vaccine strains.The two vaccine strain cases were both 2-year-old girls who had received one dose of varicel

关 键 词：水痘疫苗 带状疱疹后神经痛 野毒株 疫苗株 临床特征 监测 

分 类 号：R752.11[医药卫生—皮肤病学与性病学]