兰州大学机构库 >学院待认领
兰州地区儿童病毒性腹泻的流行病学研究
Alternative TitleEpidemiological Study on Viral Diarrhea among Children in Lanzhou
向静瑶
Thesis Advisor李宇宁 ; 段招军
2014-05-16
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword病毒性腹泻 儿童 轮状病毒 博卡病毒
Abstract目的:了解2012~2013年度兰州地区人轮状病毒、博卡病毒、杯状病毒、星状病毒、肠道病毒和腺病毒等引起儿童腹泻常见病毒的流行病学特点,为预防和控制儿童腹泻提供科学依据。 方法:采集兰州大学第一医院2012年7月至2013年6月5岁以下住院腹泻患儿的331份粪便标本,同时应用个案表采集个人信息及临床信息。酶联免疫吸附试验(ELISA法)初步检测A组人轮状病毒,巢式聚合酶链反应(Nested- PCR)进一步对阳性标本进行A组人轮状病毒的G/P分型;采用巢式PCR检测人博卡病毒;采用RT-PCR或PCR对杯状病毒、星状病毒、肠道病毒和腺病毒进行扩增。所有阳性标本进行基因测序。 结果:1、人轮状病毒阳性率为45.32%(150/331),占六种病毒检出率的首位。VP7分型中,G9型首次在兰州地区检出率最高(84.00%),其次是G3型12.67%,G1型1.33%,G2及G1+G9型均为0.67%,未检测出G4型;VP4分型中P[8]型占绝大多数(96.97%),P[4]及P[4]+P[8]型均2例(1.33%),P[6]型1例(0.67%);最常见的G/P组合是G9P[8],其次是G3P[8]。31.33%的轮状病毒与其他病毒混合感染,与博卡病毒混合为主。轮状病毒腹泻无明显季节分布,于3月出现最高峰。患儿年龄范围为0-28月龄,中位年龄为9月龄,高发年龄是7-12月龄。18月龄以下患儿轮状病毒的检出率为96.0%。轮状病毒阳性患儿的呕吐率、发热率高,分别为66.0%、67.3%,腹泻的频率(>5次/天)、呕吐的频率(>3次/天),与轮状病毒阴性患儿相比偏高。 2、331份标本中人博卡病毒阳性率为14.80%(49/331),HBoV1-4分别检测出26例、15例、7例、1例。HBoV相关的腹泻全年散发,无明显季节分布。HBoV感染的患儿年龄范围为1-32月龄,中位年龄为10月龄,高发年龄是7-12月龄。2岁以下患儿占HBoV阳性患儿总数的93.88%。HBoV与其他病毒混合感染率为71.3%,以混合轮状病毒为主。HBoV感染对腹泻患儿的发热和呕吐发生率无明显影响。检测出一例罕见的HBoV4病毒 LZFB086,与泰国(序列号JQ267789)参考株的同源性为99.0%。未检测出HBoV2B型。 3、通过对杯状病毒、星状病毒、肠道病毒和腺病毒的研究,结果如下:杯状病毒的检出率(12.99%)仅次于轮状病毒和博卡病毒,其中76.74%为诺如病毒,23.26%是札如病毒。诺如病毒以GII/4为主(48.48%),其次是GII未分型(24.24%)。星状病毒检出率为7.85%(26/331),1型占88.46%。肠道病毒阳性率为5.74%,脊髓灰质炎病毒占63.16%,其余为柯萨奇病毒,未检出埃可病毒。腺病毒阳性率为4.53%(15 /331),F组有10例,其中41型7例,40型检出3例,同时还检测到A组的31型3例,C组的2型和5型各1例。 结论:1、轮状病毒是兰州地区儿童病毒性腹泻的主要病原体,G9型首次在兰州地区检出率最高,将G9基因型引入现有疫苗株具有重要意义。 2 .人博卡病毒1-4型在兰州地区均有流行,以HBoV l为主,在我国儿童粪便中首次发现HBoV4病毒。HBoV可能不是导致急性胃肠炎的致病病原。
Other AbstractObjectives: To analyze the feature of epidemiology and clinical characteristics of Group A rotaviruses (GARV), Human Bocavirus (HBoV), Human Calicivirus (HuCV), Human Astrovirus (HAstV), Enterovirus (HEV) and Human Adenovirus (HAdV) in Lanzhou area of China from July 2012 to June 2013, and to provide scientific data for the prevention and control of children diarrhea. Methods:A total of 331 stool samples were collected from hospitalized children less than five years with acute infection diarrhea, in Department of Pediatrics, the First Hospital of Lanzhou University, between July 2012 and June 2013. Personal information and Clinical data were collected from all children. Group A rotavirus was identified by enzyme immunoassay (EIA). Rotavirus G serotype, P serotype and HBoV were confirmed by nested-PCR. HuCV, HAstV, HEV and HAdV were detected by reverse transcription-Polymerase Chain Reaction (RT-PCR) or PCR. The positive stool samples were sequenced. Results: 1.Of the 331 stool samples, 45.32% were rotavirus-positive. GARV was the most prevalent virus. The results indicated that G9 (84.00%) has gotten the highest detection rate for the first time, followed by G3 (12.67%), G1(1.33%), G2 and G1+G9 (1.33%). No G4 was detected. P[8] accounted for the most majority (96.97%), P[4] and P[4] + P[8] type were 2 cases (1.33%), P[6] was 1 cases (0.67%).The most common G/P combination identified was G9P[8], followed by G3P[8]. The most common co-infections were Rotaviruses and Bocavirus. GARV was no obvious distribution of seasons, peaked in March. The median age was 9 months (rang, 0 month to 28 months). Of all episodes of rotavirus diarrhea, 96.0% occurred during the frist 18 months, peaking at 7-12 months. Compared with non-GARV, GARV infections can be associated with severe clinical presentation, including vomiting (66.0%), fever (67.3%), frequency of diarrhea(>5 times/day) (57.3%) and frequency of vomiting(>3 times/day) (40.4%). 2.Among the 331 stool samples, 14.8%(49/331) were bocavirus-positive. We found human bocavirus 1, 2 ,3 and 4 at respective 26 ,15,7 and 1 cases. The seasonal distribution of HBoV was throughout the year. HBoV was mostly found in children aged from 7 to 12 months with a median age was 9 months. The children under 2 years old were the most susceptible population for HBoV infection (93.88%). 71.3% of the mixed infections was detected and the majority were rotaviruses. There was no statistic difference in incidence of fever and vomitin...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223115
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
向静瑶. 兰州地区儿童病毒性腹泻的流行病学研究[D]. 兰州. 兰州大学,2014.
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