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

Study on Clinical Characteristics and Molecular Epidemiology of Younger than 5 Years Old Children with Diarrhea Caused by Rotavirus Infection in Nanjing City in 2009-2010

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 serotype and the gene variation uf rotavirus in Nanjing Children＇s Hospital from Jul. 2009 to Jun. 2010. Methods From Jul. 2009 to Jun. 2010 in Department of Gastroenterology of Nanjing Children＇s Hospital Affiliated to Nanjing Medical University, stool samples were collected from 300 hospitalized children with diarrhea. Stool specimens were stored in - 20 ℃ Rotavirus antigen was detected in stool samples using a commercial enzyme linked immunosorbent assays （ELISA）. Positive specimens were then G and P genotyped by nested RT - PCR with type - specific primers. Resttlts Rotavirus were identified in 37.67% （113/300 cases）of 300 specimens. Rotavirus G3 （44 cases ,38.94% ）was the most prevailing serotype, followed by G2 （10 cases,8.85% ）, G1 （2 cases, 1.77% ） , G2 ＋ G3 （2 cases, 1.77% ）, G9 （ 1 case ,0.88% ） ,54 cases （47, 79% ） were not genotyped. Based on P typing,P [8] （38 cases,33.63% ） was the most common genotype,followed by P[4] （19 cases,16.81% ） ,56 cases （49.56%） were not genotyped. The most common G - P combination was G3P [ 8 ] （ 18/113 cases, 15.93% ）. The prevalence of HRV infection was highest from Oct. 2009 to Jan. 2010. The majority （95.58%） of subjects positive for HRV were 2 years old or less of age, The HRV positive cases had more serious clinical features than HRV negative eases. Conclusion Rotavirus is the most important pathogerl for gastroenteritis in Nanjing,and G3P[ 8] is the most prevailing serotype.