上海婴幼儿病毒性腹泻的病原学研究

Pathogenic study on viral diarrhea of infants and young children in Shanghai

目的研究上海5岁以下婴幼儿病毒性腹泻的病原学情况。方法采集2012年1月-2013年5月复旦大学附属儿科医院5岁以下腹泻患儿粪便标本160份,对病毒的VP1区等易于分型的特征序列扩增后进行测序比对,检测样本中是否含有诺如病毒(NV)、札如病毒(SAV)、轮状病毒(RV)、星状病毒(ASV)、腺病毒(ADV)以及包括脊髓灰质炎病毒(PV)、柯萨奇病毒(COX)和埃可病毒(ECHO)在内的肠道病毒(EV)。结果 160份腹泻标本中共检出含有上述病毒的样本45份,检出率为28.13%。除ADV外,其他7种病毒均有检出,其中检出NV 23例、SAV 5例、RV A 11例、ASV 3例、COX 2例、PV和ECHO 30各1例,其中1例为NV和ECHO 30混合感染。检出的NV均为GⅡ型,其中78.3%为GⅡ.4型,21.7%为GⅡ.3型;11例RV A中,G3P[8]6例,G2P[4]4例,G1P[8]1例;3例ASV阳性样本中,2例为ASV 1,1例是ASV 5。PVⅡ、ECHO 30、COX A4和COX A9各1例。结论上海地区婴幼儿病毒腹泻的感染致病病毒以NV GⅡ和RV A为主。

Objective Pathogenic study on viral diarrhea in infants and children under 5 year- old in Shanghai was performed.Methods 160 diarrhea faeces samples have been collected from children under 5 year- old from January 2012 to May 2013 in children＇s hospital of Fudan university. The characteristic sequence of viruses,such as VP1 region,was amplified and sequenced to detect and analyze the virus and its genotype. Enteric viruses（ EV） were tested,including norovirus（ NV）,sapovirus（ SAV）,rotavirus（ RV）,astrovirus（ ASV）,adenovirus（ ADV）,poliovirus（ PV）,coxsackievirus（ COX） and echovirus（ ECHO）. Results 45 samples out of 160 were detected containing at least one mentioned virus with the detection rate of 28. 13%.Except for ADV,the other 7 viruses were detected including 23 samples were detected with NV,5 samples with SAV,11 samples with RV A,3 samples with ASV,2 samples with COX and 1 sample with PV and ECHO 30,including 1 co- infection of NV and ECHO 30 viruses. The detected NV were GⅡ,78. 3% were GⅡ. 4,21. 7% were GⅡ. 3; In 11 cases of RV A,there were 6 samples with G3P[8],4 samples with G2P[4],1 sample with G1P[8],respectively. Of the 3 ASV positive samples,2 samples were ASV 1,and 1 sample were ASV 5. And 1 sample was detected with PVⅡ,ECHO30,COX A4 and COX A9 infection. Conclusion Infantile diarrhea caused by viral infection in Shanghai was mainly focused on the pathogenic virus of NV GⅡ and RV A.