从化市婴幼儿急性呼吸道人类偏肺病毒感染与基因分析

Infection and genetic analysis on human metapneumovirus in infants with acute respiratory in Conghua city

目的了解从化市婴幼儿急性呼吸道人类偏肺病毒（humanmetapneumovirus，hMPV）感染的流行病学特点及临床特征，为防治hMPV感染提供指导依据。方法采集289例婴幼儿急性呼吸道感染鼻咽拭子标本，采用反转录一聚合酶链式反应（RT—PCR）检测hMPV的核蛋白（N）基因，随机选取8例hMPV强阳性PCR产物进行测序和序列分析，同时对采集病例的临床资料进行统计学分析。结果289例标本中有20例（6．92％）为N基因阳性。2月份至4月份hMPV阳性检出率较高，以4月份最高（27．9％），且多为1岁以内婴儿（80．0％）。hMPV阳性患儿的临床表现主要为卡他症状、发热、咳嗽、喘息、气促、肺部哕音和肺部影像学改变等，可引起上、下呼吸道感染。对N基因进行测序与序列分析，结果与GenBank中的序列比对，与北京株BJl897N基因的序列同源为97％。结论hMPV感染是从化市婴幼儿急性呼吸道感染的原因之一，发病高峰在4月份，且多为1岁以内婴儿。临床表现以咳嗽、喘息、肺部哕音和肺部影像学改变为主。8例hMPV阳性PCR产物核苷酸序列与北京株BJl897N基因的序列同源为97％。

Objective To study the clinical and epidemiological characteristics of human Metapneumovirus （hMPV）, and provide basic guidance for preventing and treating hMPV infection in Conghua city. Methods Nasopharyngeal swab specimens of infections with acute respiratory had been collected from 289 cases for inspection. Reverse transcription-polymerase chain reaction （RT-PCR） technique had been employed to identify the hMPV nucleoprotein （N） gene. PCR products of 8 strong hMPV positive cases were selected to perform sequencing and alignment analysis. We collected clinical data and analyzed them statistically. Results Twenty out of the 289 total cases （about 6.92%） were identified to be hMPV positive. Infants born between February and April showed relatively higher positive rate. The highest positive rate was observed in April （about 27.9%）. Most of the infants （about 80.0%） were less than one year old. An hMPV infection can cause upper and lower respiratory tract infections. The main clinical manifestations associated with hMPV positive patients included catarrhal symptoms, fever, coughing, wheezing, shortness of breath, pulmonary rales and radiographic changes in the lungs. The results of N gene sequencing and alignment analysis were compared with the Beijing strain BJ1897N gene sequence, the homology rate was about 97%. Conclusion hMPV infection is one of the reasons causing respiratory infections in infants in Conghua city. In this study, the infection incidence rate peaked in April, and more of the infants were less than one year old. The main clinical manifestations were coughing, wheezing, pulmonary tales and pulmonary imaging changes in thelungs. The homology rate of eight strong hMPV positive cases with the Beijing strain BJ1897N is about 97%.