郑州地区秋冬季腹泻患儿轮状病毒基因分型及干预研究

The Analysis and Intervention Study about Genotypes of Rotavirus in Infantile Diarrhea in Zhengzhou from Autumn to Winter

目的：研究2011-2013年郑州地区秋冬季腹泻患儿轮状病毒基因分型及疫苗干预后再感染情况。方法：收集郑州市第一人民医院及郑州人民医院儿科2011年9月-2012年3月及2012年9月-2013年3月门诊及住院部秋冬季腹泻患儿（小于5岁）的粪便标本900份,采用酶联免疫吸附试验（ELISA）方法检测RV抗原,阳性标本进行VP7和VP4基因分型。结果：900份粪便标本中,612份检测到轮状病毒抗原,阳性率为68.0%（612/900）;对612份阳性标本进行G血清型分型,G3型214份（35.0%）,G9型109例（17.8%）,G1型98例（16.0%）,G2型68例（11.1%）,混合型86例（14.1%）,未分型37例（6.0%）,未发现其他G血清型。612份阳性标本进行P基因分型,P8型349例（57.0%）,P4型85例（13.9%）,P6型36例（5.9%）,混合型91例（14.9%）,未分型51例（8.3%）。2011年9月-2012年3月轮状病毒G血清型以G3型为主,和P型的组合G3P8型为主。2012年9月-2013年3月以G9型为主,和P型的组合G9P8型为主。轮状病毒腹泻发病高发季节为9-12月,高发年龄段为6~24个月,平均发病月龄为（10.1±7.2）个月。口服RV疫苗干预后再次感染的患儿以混合型感染者居多,且临床表现较未使用者表现轻。结论：郑州地区RV腹泻患儿流行病毒株多样,混合感染比例增加,以往不常见的基因型G9型成为主要流行病毒株,口服轮状病毒疫苗后出现感染的以混合感染型别为主,且临床表现较未使用疫苗者轻。

Objective： To study the genotypes changing and the reinfection afer vaccines interventions of rotavirus in infantile diarrhea from 2011 to 2013 in Zhengzhou.Method： Stool samples were collected from 900 children who were in hospital and outpatients in the Department of Peadiatrics in The First People＇s Hospital and The People＇s Hospital of Zhengzhou from September 2011 to March 2012, and from September 2012 to March 2013. ELISA was used to detect rotavirus genemic RNA. The positive samples were performed to identify rotavirus P and G genotypes. Result： Out of 900 samples investigated, 612 positive samples were detected rotavirus G genemic,The positive rate was 68.0%. 612 positive samples were performed to identify genotypes. G3 types were 214（35.0%）, G9 types were 109（17.8%）,G1 types were 98（16.0%）, G2 types were 68（11.1%）,the mixed cases were 86（14.1%）,37（6.0%） cases were not genotyped,other G genotypes were not detected. 612 positive samples were detected rotavirus P genemic,P8 types were 349（57.0%）,P4 types were 85（13.9%）,P6 types 36（5.9%）,the mixed types were 91（14.9%）, 51（8.3%） samples were not genotyped. G3 genotypes were dominated the main prevalence from September 2011 to March 2012, and the main mixed infection types were G3P8. G9 genotypes were dominated the main prevalence from September 2012 to March 2013, the main mixed infection types were G9P8. The high occurrence seasons for rotavirus diarrhea were September to December,the high occurrence ages were 6 months to 24 months, the average months were（10.1±7.2）months.After taking rotavirus vaccine the reinfection cases were most mixed genotypes, and the clinical manifestation was lighter than the children who were not taking rotavirus vaccine. Conclusion：The prevalent types in Zhengzhou were various. The mixed infection cases increased than ever.The uncommon G9 types were the dominated prevence genotypes. After taking rotavirus vaccine the reinfection cases were most mixed genotypes, and the clinical manifestation is lighter than the children who are not taking rotavirus vaccine.