2011-2012年北京地区急性呼吸道感染患者冠状病毒感染状况分析

Human coronaviruses infection in patients with acute respiratory tract infection in Beijing,2011-2012

目的了解北京地区急性呼吸道感染患者中冠状病毒感染状况，探讨其流行特征。方法2011—2012年，每月自北京地区5家哨点医院采集10～15份急性呼吸道感染病例咽拭子、痰液标本，并收集患者相关信息，采用反转录一聚合酶链反应（RT—PCR）检测冠状病毒，通过对阳性扩增产物核苷酸序列分析确定其型别，应用SPSS17．0软件进行统计学分析。结果共检测急性呼吸道感染病例样本1619份，检出冠状病毒阳性样本20份，总阳性率为1．24％，其中9份为急性上呼吸道感染，11份为急性下呼吸道感染，检出阳性率分别为1．11％和1．36％；OC43型阳性13份，229E型阳性6份，NL63型1份。2011年阳性检出率（1．82％，14／769）高于2012年（0．71％，6／850），差异有统计学意义（，=4．112，P=0．043）；不同月份检出阳性率差异无统计学意义；229E型冠状病毒在2011年与2012年的检出率差异有统计学意义（，=4．711，P=0．03）。25～59岁年龄组检出阳性率最高，为1．96％；其次为0～4岁组，检出阳性率为1．92％，其余年龄组均低于1％，各年龄组的阳性率差异有统计学意义。OC43型在0—4岁婴幼儿组与25～59岁成人组中有较高的检出阳性率，差异有统计学意义（∥=5．007，P=0．026）。不同性别患者中冠状病毒检出阳性率差异无统计学意义。不同型别冠状病毒感染导致的急性上呼吸道感染与急性下呼吸道感染及临床症状表现上差异无统计学意义。结论2011--2012年北京地区冠状病毒感染主要是OC43和229E两种型别；不同年份冠状病毒流行强度及流行型别有一定差异，但其流行季节特征不明显；婴幼儿及成年人是冠状病毒感染的主要人群，并以OC43型为主。不同型别冠状病毒导致的临床症状无明显差异。

Objective To understand the infection status of human coronaviruses （HCoVs） in patients with acute respiratory tract infection and epidemiological characteristics of HCoVs infection in Beijing. Methods From 2011 to 2012, throat swabs or sputum samples were collected from the patients with acute respiratory tract infection in 5 sentinel hospitals in Beijing, the patients＇ basic information were collected too. All the samples were tested with RT-PCR using specific primers to detect HCoV. The positive amplicons were sequenced to identify the virus type. The results were analyzed with SPSS 17. 0. Results Twenty samples were HCoV positive in 1619 samples （ 1.24% ）, including 9 from the patients with upper respiratory tract infection （1.11%） and 11 from the patients with lower respiratory tract infections （ 1.36% ）. Among 20 positive samples, 13 were OC43, 6 were 229E, 1 was NL63. The positive rate was higher in 2011 （ 1.82%, 14/769 ） than in 2012 （0. 71% ,6/850）, the difference was statistically significant （X2 = 4. 112, P = 0. 043 ）, but the differences in monthly positive rates had no statistical significance, The age specific positive rate in age group 25 - 59 years was highest （ 1.96%, 13/663 ）, followed by age group 0 - 4 years （ 1.92%, 3/208 ） and other age groups （ 〈 1% ）. The differences in age specific positive rates were statistically significant. The positive rates of OC43 in age groups 25 -59 and 0 -4 years were high, the difference had statistical significance （X2 = 5.007, P = 0. 026）. The difference in gender specific positive rate of HCoVs had no statistical significance. The differences inclinical symptoms caused by different types of HCoVs were not statistically significant. Conclusion During 2011 - 2012, HCoV -229E and HCoV-OC43 were the predominant HCoVs in Beijing. The circulating type and related intensity varied with year but had no obvious seasonality. Infants/young children and adults are the risk populations of HCoVs infection, especially HCoV-OC43 infection. The differences in clinical symptoms caused by different types of HCoVs are not statistically significant.