2009-2010年南京地区5岁以下儿童轮状病毒性腹泻临床特点及分子流行病学研究

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目的了解2009年7月-2010年6月南京地区轮状病毒性腹泻的流行病学情况及病毒的血清及基因分型特点,为轮状病毒感染性腹泻的防治提供科学依据。方法收集2009年7月-2010年6月本科随机留取水样泻患儿粪便标本300份,标本采集后立即保存于-20℃冰箱,集中进行病毒检测和数据分析。使用ELISA法检测A组人类轮状病毒(HRV),应用Trizol法提取HRVRNA,反转录合成病毒cDNA,采用巢式反转录PCR法对HRV标本进行G血清型和P基因型分型。结果 300份患儿粪便标本中113份标本检测出A组HRV,阳性率为37.67%。G血清型最常见的为G3型[44份(38.94%)],其次为G2型[10份(8.85%)],G1型、G2+G3型各2份(1.77%),G9型1份(0.88%),未能分型54份(47.79%);P基因型最常见的为P[8]型[38份(33.63%)],其次为P[4]型[19份(16.81%)],未能分型56份(49.56%),未发现P[6]、P[9]、P[10]型。G血清型和P基因型组合以G3P[8]为主(18/113例,15.93%)。南京地区HRV腹泻季节高峰在10月份-次年1月份,95.58%的腹泻儿童在2岁以前感染过HRV,HRV组发热率、腹泻次数、出现呕吐和脱水症状的概率与HRV阴性组比较差异均有统计学意义(Pa<0.05)。结论 HRV是引起南京地区婴幼儿水样泻的最主要的病原体,以G3P[8]为主要优势株。 Objective To understand the epidemiology of rotavirus diarrhea and the serum and genotyping characteristics of the virus from July 2009 to June 2010 in Nanjing, and to provide a scientific basis for the prevention and treatment of rotavirus infectious diarrhea. Methods From July 2009 to June 2010, 300 samples of stool samples of children with water samples were collected randomly. The samples were collected and stored in -20 ℃ refrigerator immediately for virus detection and data analysis. A group of human rotavirus (HRV) was detected by ELISA. The HRV RNA was extracted by Trizol method and the cDNA was reverse transcribed. The genotypes of G serotype and P were genotyped by nested reverse transcription PCR. Results A total of 113 specimens from 300 stool specimens of children were tested for HRV in group A, with a positive rate of 37.67%. The most common G serotypes were G3 [44 (38.94%)] followed by G2 [10 (8.85%)], two copies of G1 and G2 + G3 (1.77% (P <8) [38 (33.63%)], followed by P [4] [19 (16.81% ), Failed to type 56 (49.56%), did not find P [6], P [9], P [10] type. G serotypes and P genotype combinations G3P [8] (18/113 cases, 15.93%). In the period from October to January, 95.58% of children with diarrhea were infected with HRV before the age of 2 years. The incidences of fever, diarrhea, vomiting and dehydration in HRV group were significantly lower than those in HRV negative group There was statistical significance (Pa <0.05). Conclusion HRV is the most important causative agent of infantile watery diarrhea in Nanjing. G3P [8] is the main predominant strain.
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