河南省信阳市2019年—2021年发热伴血小板减少综合征病原学检测结果分析

Analysis of pathogenic detection results of severe fever with thrombocytopenia syndrome in Xinyang City,Henan Province from 2019 to 2021

目的 分析河南省信阳市2019年—2021年发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome, SFTS)病原学检测结果,为进一步预防和控制发热伴血小板减少综合征提供依据。方法 收集临床发热伴血小板减少综合征病例急性期血清标本,应用实时荧光定量PCR(RT-PCR)方法检测新布尼亚病毒(severe fever with thrombocytopenia syndrome bunyavirus, SFTSV)。对部分分离到的病毒株S片段基因进行扩增和同源性分析,构建系统进化树。结果 502份样本中,新布尼亚病毒核酸检测阳性192份,总阳性率为38.25%;不同年份阳性率差异有统计学意义(χ^(2)=31.013,P=0.000);男女新布尼亚病毒阳性率差异有统计学意义(χ^(2)=6.340,P=0.012);阳性率以70岁~79岁组最高,各年龄组差异有统计学意义(χ^(2)=28.679,P=0.000);农民占病例总数的80.21%;发病集中在4月—10月,5月出现发病高峰,发病在时间上存在集中趋势(Z=2.764,P<0.05);病例主要集中在商城县、光山县、平桥区和罗山县;基因测序有16份标本获得S片段基因全长,分离的16株新布尼亚病毒S片段核苷酸同源性为95.01%~99.94%;15株为基因A型,1株为基因E型。结论 信阳市发热伴血小板减少综合征具有明显地域性和季节性,女性、农民、大年龄组高发,新布尼亚病毒主要流行型别为A基因型,仍需持续开展病原监测。

Objective This paper sought to analyze the pathogenic detection results of severe fever with thrombocytopenia syndrome(SFTS)in Xinyang City,Henan Province from 2019 to 2021,so as to provide basis for the further prevention and control of SFTS.Methods The serum samples of patients with SFTS in the acute stage were collected and conducted for the detection of severe fever with thrombocytopenia syndrome Bunyavirus(SFTSV)by real-time quantitative fluorescence RT-PCR.The phylogenetic tree was constructed by amplification and homology analysis of some of the isolated S fragment genes.Results Among 502 samples,192 were positive for nucleic acid detection of SFTSV,with a total positive rate of 38.25%.The positive rate in different years was of statistics significance(χ^(2)=31.013,P=0.000).The difference in the infection rate of SFTSV between men and women was of statistics significance(χ^(2)=6.340,P=0.012).The infection positive rate of the 70-79 year old group was the highest,and there was statistical significance on the difference among the age groups(χ^(2)=28.679,P=0.000).Farmers accounted for 80.21%of the total cases,the onset outbreak was concentrated from April to October and peaked in May,showing a concentrated tendency(Z=2.764,P<0.05).The cases were mainly observed in Shangcheng County,Guangshan County,Pingqiao District and Luoshan County.The full length of S segment gene was obtained from 16 samples of gene sequencing,and the nucleotide homology of S segment of 16 strains of SFTSV was between 95.01%to 99.94%.15 strains were genotype A and 1 strain was genotype E.Conclusion SFTS in Xinyang City displays regional and seasonal characteristics,with high incidence among women,farmers and older groups.The main epidemic type of SFTSV is genotype A,which still requires continuous pathogen monitoring.