人腺病毒感染结膜炎临床和基因型特征及泪液免疫球蛋白水平  

Clinical and genetic characteristics of conjunctivitis patients with adenovirus infection and levels of immunoglobulins in tear

作　　者：黄蔓鑫 杜薇 陈颖 HUANG Man-xin;DU Wei;CHEN Ying(Medical Department of Jianghan University,Wuhan,Hubei 430056,China;不详)

机构地区：[1]江汉大学医学部,湖北武汉430056 [2]武汉大学附属爱尔眼科医院眼科,湖北武汉430050 [3]武汉市硚口区古田街社区卫生服务中心公共卫生科,湖北武汉430000

出　　处：《中华医院感染学杂志》2024年第22期3457-3461,共5页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2014CFB9732014CFB442)。

摘　　要：目的分析人腺病毒(HAdV)感染结膜炎临床和基因型特征及泪液免疫球蛋白水平。方法收集2019年12月-2023年12月在武汉大学附属爱尔眼科医院眼科就诊的428例结膜炎患者为病例组,另随机选取同期眼科正常健康检查者40名为对照组。使用荧光定量聚合酶链反应(PCR)分析HAdV感染情况,使用生物信息学软件对测序后序列信息进行HAdV基因型特征分析,比较不同基因型HAdV阳性患者临床特征,比较不同基因型HAdV阳性患者与对照组泪液免疫球蛋白水平差异。结果428份结膜炎患者眼拭子样本中,HAdV阳性138例,占32.24%。138例HAdV阳性的结膜炎患者中,以8型(50.72%)、3型(23.20%)和19/37型(21.01%)为主;3型、8型和19/37型临床表现在畏光流泪和眼刺痛具有统计学差异(P<0.05),在眼结膜充血、烧灼感、视物不清、肿胀、角膜浸润、异物感、黏液分泌物、眼睑沉重、水样分泌物及低热比较,无统计学差异;不同基因型HAdV阳性者泪液免疫球蛋白(Ig)A、IgM、IgG水平均高于对照组(P<0.05),不同基因型组间无统计学差异。结论结膜炎患者中HAdV感染较高,以8型HAdV居多,不同基因型HAdV感染结膜炎患者临床表现相似,免疫球蛋白水平高于正常人群。OBJECTIVE To investigate the clinical and genetic characteristics of the conjunctivitis patients with human adenovirus(HAdV)infection and analyze the levels of immunoglobins in tears.METHODS A total of 428 patients with conjunctivitis who were treated in ophthalmology department of Aier Ophthalmology Hospital Affiliated to Wuhan University from Dec.20196 to Dec.2023 were assigned as the case group,meanwhile,40 healthy people who received physical examination in ophthalmology department were chosen as the control group.The prevalence of HAdV infection was analyzed by means of florescent quantitative polymerase chain reaction(PCR).The genotypes of HAdV were analyzed by using bioinformatics soft after gene sequencing,the clinical characteristics were compared among the HAdV-positive patients with different genotypes,and the levels of tear immunoglobulins were compared between the HAdV-positive patients with different genotypes and the control group.RESULTS Among the 428 patients with conjunctivitis from whom the eye swab specimens were obtained,138 were tested positive for HAdV,accounting for 32.24%.Of the 138 HAdV-positive patients with conjunctivitis,50.72%were the type 8,23.20%were type 3,and 21.01%were type 19/37.There were significant differences in clinical manifestations such as photophobia,lacrimal punctum and eye tingling among the type 3,type 8 and type 19/37 patients(P<0.05);there were no significant differences in conjunctival congestion,burning sensation,blurred vision,swelling,corneal infiltration,foreign body sensation,mucus secretion,heavy eyelids,water-like secretion and low fever among the patients.The levels of tear immunoglobulin(Ig)A,IgM and IgG of the HAdV-positive patients with different genotypes were higher than those of the control group(P<0.05);there were no significant differences in the above indexes among the patients with different genotypes.CONCLUSIONS The HAdV infection is highly prevalent among the conjunctivitis patients,among whom the patients have type 8 HAdV infection are domina

关 键 词：结膜炎 腺病毒 基因型 泪液 免疫球蛋白 

分 类 号：R777.31[医药卫生—眼科]