深圳宝安区急性下吸呼道感染门诊患儿人偏肺病毒感染率及基因分析

Infection rate and gene analysis of patients with acute exhalation infection in baoan district Shenzhen

目的了解深圳宝安区急性下呼吸道感染(acute lower respiratory tract infection,ALRTI)门诊患儿人偏肺病毒(human metapneumovirus,h MPV)感染率及其优势亚型分析。方法收集2015年1月~2016年12月来深圳宝安区福永人民医院就诊的ALRTI门诊患儿760例,同期健康儿童120例,分别采用One-step RT-PCR法检测咽拭子标本中的h MPV,从h MPV阳性患儿中随机选取8例,对其扩增产物进行正反测序,并将所得基因序列与Gen Bank中的代表株进行比对分析。结果 760例ALRTI门诊患儿咽试子标本中检出h MPV 153例,阳性率为20.13%(153/760),其中男患儿为10.66%(81/760),女患儿为9.47%(72/760),男患儿略高于女患儿,但差异无统计学意义(χ2=1.072,P>0.05),而120例健康儿童咽拭子标本均未检测h MPV。1岁以下ALRTI门诊患儿h MPV阳性率为30.81%(61/198),明显高于其它年龄段,差异均有统计学意义(χ2=6.506,P<0.05;χ2=9.023,P<0.05;χ2=12.067,P<0.01)。1~3月份ALRTI门诊患儿h MPV阳性率为48.76%(138/283),明显高于其它月份,差异均有统计学意义(χ2=13.197,P<0.01;χ2=14.385,P<0.01;χ2=8.207,P<0.05)。8株h MPV阳性毒株的病毒核苷酸与代表株的同源性为92.0%~99.6%,8株h MPV毒株之间核苷酸同源性为91.2%~98.0%。h MPV感染同时存在A和B两种基因,且A2b,B1和B2为本区优势亚株。结论 h MPV是引起2015年~2016年深圳宝安区ALRTI门诊患儿感染的主要病原体之一,多发于冬春季节和1岁以下儿童,且A2b,B1和B2为本区优势亚株,应引起临床高度重视。

Objective：To understand the infection rate of human metapneumovirus（h MPV）of patients with acute lower respiratory tract infection（ALRTI）in Shenzhen Baoan area,and its dominant subtype analysis. Methods：Collected from January 2015 to December 2016 to Shenzhen Baoan district Fuyong People＇s Hospital ALRTI outpatient children with 760 cases,120 cases of healthy children during this period,the One-step rt-pcr method were used respectively to detect h MPV in throat swab specimens,8 cases were randomly selected from h MPV positive patients,the amplification products were positive and negative sequence,and the gene sequence and the representative strains in Gen Bank comparative analysis. Results：760 cases of children with ALRTI outpatient pharynx try child specimens detect h MPV 153 cases,positive rate was 20.13%（153/760）,the male patients was 10.66%（81/760）,female patients was 9.47%（72/760）,male with slightly higher than the female children,but there was no statistically significant difference（χ2=1.072,P1.072）,and 120 healthy children′s throat swab specimens were not detect h MPV. The positive rate of h MPV was 30.81 per cent（61/198）for children under 1 year old ALRTI,significantly higher than other age groups,and the difference was statistically significant（χ2=6.506,P〈0.05;χ2=9.023,P〈0.05;χ2=12.067,P〈0.01）The positive rate of h MPV was 48.76%（138/283）in the ALRTI outpatient clinic in January to march,significantly higher than the other months,and the difference was statistically significant（χ2=13.197,P〈0.01;χ2=14.385,P〈0.01;χ2=8.207,P〈0.05）. The nucleotide and the homology of the 8 h MPV positive strains were 92.0% ~ 99.6%,and the nucleotide homology of the 8 h MPV strains was 91.2% ~ 98.0%. HMPV infection has both A and B genes,and A2 b,B1 and B2 are the dominant substrains of the region. Conclusion HMPV is shenzhen baoan district from 2015 to 2016 in one of the main pathogens of infection in children with ALRTI clinic,happens in the winter and spring seasons and children under the age of 1,and A2 b,B1 and B2 for the advantage of strains,clinical attaches great importance to it.