深圳汕头地区呼吸道感染患儿人偏肺病毒的检出及病原学初步研究

Identified and Etiological Study on Human Metapneumovirus in Children with Respiratory Tract Infection in Shenzhen and Shantou Area

目的：了解人偏肺病毒（hMPV）在深圳汕头地区的感染情况及临床特征。方法收集2010年10月～2012年6月呼吸道感染住院患儿及健康体检儿童鼻咽抽吸物及咽拭子标本共1217例，采用 RT-PCR方法对其进行 hMPV基因筛查，随机选取5份扩增阳性产物进行核酸测序，将所得序列与 GenBank中的序列进行比较和进化树分析。同时，对阳性标本的临床资料进行分析。结果1137份感染患儿标本中检测到hMPV 51份（阳性率4.49％），2，3，4月为发病高峰，感染患儿主要在3岁以下，占检出率的80.4％，5份阳性标本基因序列与 GenBank 中公布的多株 hMPV N 基因同源性达80.8％～98.4％。进化树分析显示分属于两个不同的基因进化族。51例阳性患儿临床症状均表现为发热、咳嗽、喘息，临床诊断主要为支气管肺炎24例，喘息型肺炎17例，毛细支气管炎9例，上呼吸道感染1例。80例健康体检儿童的呼吸道标本均未检测到 hMPV特异基因片段。结论 hMPV是引起深圳汕头地区3岁以下儿童呼吸道感染的重要病原体之一，并有一定的季节性，其感染无特异的临床表现。流行的 hMPV株存在两种不同基因型。

Objective To analyze the status of human metapneumovirus in children with respiratory tract infection in Shenz-hen and Shantou and the clinical characteristics of the diseases with hMPV infection.Methods The viral nucleic acid of 1 217 samples were amplified by RT-PCR（1 137 from children with respiratory tract infection,80 from health children）,and five positive PCR products were chosen randomly for sequencing.Nucleotide sequences alignment and phylogenetic analysis were performed with DNAstar software.The clinical data of the children with hMPV infection were analyzed.Results The positive rate of hMPV infection identified from 1 137 children wtith respiratory tract infection was 4.49% （51/1 137）, hMPV was significantly prevalent in February,March and April.Most of the positive cases was under 3 years old.Five hMPV gene fragments of sequence were closely related to hMPV in the GenBank.Similarity of hMPV partial N gene with which published at nucleotide levels varied from 80.8%～98.4%.Phylogenetic tree of nucleotide revealed two different gen-otypes.All hMPV positive patients suffered from fever,cough and wheezing.The clinical diagnoses were wheezing pneumo-nia （17）,bronchiolitis （9）.None of the nasal swabs from 80 healty subjects were tested hMPV specific gene fragment.Con-clusion hMPV is an important viral pathogen in children with respiratory tract infection in Shenzhen and Shantou.Two genotypes may circurate in these areas.