北京地区儿童2型人博卡病毒与急性腹泻的相关性

Correlation between human bocavirus 2infection in children and acute diarrhea in Beijing

目的探讨2型人博卡病毒(HBoV2)感染与5岁以下儿童急性腹泻的相关性。方法本研究为前瞻性病例对照研究,似2016年5至12月首都儿科研究所附属儿童医院≤5岁的急性腹泻患儿为病例组,同时期北京龙潭社区医疗服务中心健康查体的相应年龄段无腹泻症状的儿童作为对照组;病例组与对照组各分为8个年龄组:≤1月龄、>1—3月龄、>3~6月龄、>6—12月龄、>1—2岁、>2~3岁、>3—4岁及>4—5岁,每年龄组30例,各入组240例。收集粪便标本,利用实时荧光PCR方法进行包括HBoV2在内的7种腹泻相关病毒筛查;根据循环阈值(Ct)估计HBoV2病毒载量;应用t检验比较组间差异。结果病例组240例患儿粪便标本中,病毒阳性检出率从高到低依次是诺如病毒16.7%(40例)、轮状病毒10.8%(26例)、HBoV27.5%(18例)、腺病毒7.1%(17例)、星状病毒6.3%(15例)、副肠孤病毒3.8%(9例)和爱知病毒0.4%(1例)。病例组HBoV2阳性检出率与对照组(5.0%,12例)差异无统计学意义(x^2=1.280,P=0.258),相应的各年龄组间差异也均无统计学意义(P均>0.05),但病例组HBoV2阳性标本的平均病毒载量明显高于对照组[1x10。拷贝数/L(Ct值25.8)比lx10^5拷贝数/L(Ct值33.8),t=O.597,P=0.000]。结论诺如病毒、轮状病毒依然是儿童急性腹泻的重要病毒病原。与低病毒载量的HBoV2相比,高载量的HBoV2更易在5岁以下儿童中引起急性腹泻。

Objective To investigate the relationship between human bocavirus 2(HBoV2) infection and acute diarrhea in children younger than 5years of age in a case-control study.Methods This was a prospective case-control study.During May 2016to December 2016,fecal specimens were collected from children ≤5years of age with acute diarrhea who visited the Affiliated Children's Hospital of Capital Institute of Pediatrics (case group),or from children ≤5years of age without diarrhea from Longtan Community Medical Service Center,Beijing (control group).The case group (n=240)and the control group (n= 240)were divided into 8age subgroups:≤1month old,>1-3months old,>3-6months old,>6-12months old,>l-2years old,>2-3years old,>3-4years old and >4-5years old,and there were 30cases in each age subgroup.The specimens were tested for 7types of diarrhea-associated viruses,especially for HBoV2by real- time PCR method.The HBoV2viral load was predicted according to the cycle threshold (Ct).Finally,t-test was used to compare the differences between groups.Results In the case group (n=240),the positive rate of norovirus was 16.7%(40cases);rotavirus,10.8%(26cases);HBoV2,7.5%(18cases);adenovirus,7.1% (17cases);astrovirus,6.3%(15cases);parachovirus,3.8%(9cases);and Aich virus,0.4%(1case).The positive rates of HBoV2in case group (7.5%,18cases)and control group (5.0%,12cases)showed no significant difference (X2=1.280,P=0.258),as well as in different age groups (all P>0.05).However,the mean viral load of the HBoV2in the case group (1x 109copies/L with cycle threshold (Ct)25.8)was higher than that of control group (lx 10Scopies/L with Ct 33.8),showing a significant difference (t=0.597,P=0.000). Conclusions Norovims and rotavirus are still the important viral pathogens in children with acute diarrhea.A higher load of HBoV2may indicate a higher risk of acute diarrhea in children ≤5years of age in Beijing.