兰州大学机构库 >学院待认领
2009-2010年兰州地区儿童急性呼吸道感染病原学研究
Alternative TitleA Study on Etiology of Acute Respiratory Tract Infection in Children in Lanzhou Area from 2009 to 2010
曹长青
Thesis Advisor李宇宁
2011-05-22
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword人偏肺病毒 人博卡病毒 肺炎支原体 儿童 急性呼吸道感染 实时荧光定量聚合酶链反应
Abstract实验目的 了解2009-2010年度兰州地区急性呼吸道感染(ARTIs)患儿中呼吸道相关病原谱的流行现状,重点监测人偏肺病毒、人博卡病毒、肺炎支原体,为本地区儿童急性呼吸道感染相关病原的流行病学研究积累数据,为临床抗感染治疗提供依据。同时开展荧光定量PCR法在呼吸道病原体检测中的应用。 对象及方法 1收集2009年12月至2010年11月在兰州大学第一医院儿科确诊为急性呼吸道感染的门诊和住院患儿的鼻咽分泌物(Nasopharyngea aspirates,NPAs)和咽拭子(throat swabs)标本。 2采用荧光定量RT-PCR法检测人偏肺病毒,巢氏PCR法检测人博卡病毒,同时用普通PCR方法检测10种呼吸道感染相关病毒:ADV、RSV、IFV(A、B型),HRV、PIV(1-3型)、HCOV-NL63、HCOV-HKU1,并对其进行测序和系统进化分析。结合本连续性研究4年间资料,分析相关病毒流行趋势。 3用荧光定量PCR法检测鼻咽分泌物标本中肺炎支原体并分析临床资料,了解其在兰州地区的感染情况和流行规律。同时对比检测南京地区肺炎支原体感染情况,初步了解我国东西部地区肺炎支原体感染的流行病学差异。 结果 1.本研究用Real-time RT-PCR检出人偏肺病毒阳性标本54例,检出率9.91%,在本年度呼吸道感染相关病毒中位居第四位。病毒载量分析后平均病毒载量是4.88×109拷贝/ml ,106拷贝/ml及以上人数占72.22%。阳性标本对M基因分型后21例(38.89%)分出型别,系统进化分析后显示本年度以A2b型为优势型别(47.62%)。在流行病学方面,HMPV在男女性别检出无差异,时间上以3-5月检出率较高;年龄分布上以1岁以下患儿检出数最多;2岁以上患儿检出率有下降趋势。HMPV的病毒混合感染率为57.41%,最常见混合感染病毒为RSV(38.71%)和PIV3(35.48%)。HMPV在上下呼吸道感染中的检出率无差异。阳性患儿更易出现喘息症状。 2.545份标本中共检出人博卡病毒45例,检出率8.26%,其中HBoV1型41例 , HBoV2型3例,HBoV3型1例,检出率分别为7.52%、0.55%、0.18%,未检出HBoV4型。其中HBoV1型男女性别检出率之间差异无统计学意义;夏季(7~8月)、冬季(1月、11~12月)检出率较高,检出高峰在7月,检出率为14.29%;年龄分布方面,1岁以下患儿检出24例,检出率8.63%,检出数和检出率均居首位。有较高的混合感染率(65.85%)。HBoV1型在下呼吸道感染患儿中检出率为9.14%(33/361),显著高于上呼吸道感染患儿的检出率4.35%(8/184)(χ2 =4.025,P=0.045<0.05)。HBoV1单一感染患儿与混合感染患儿临床表现之间比较差异无统计学意义。HBoV2型、3型均为混合感染。3例人博卡病毒2型阳性患儿均出现腹泻症状。 3.本年度呼吸道标本病毒检出率为62.94%(343/545)。检出率排在前三位的是HRV(108,19.82%)、RSV(106,19.45%)、PIV3(66,12.11%)。病毒检出在性别和季节分布上比较差异无统计学意义;在年龄分布上,7~12月龄患儿检出率最高(70.84%),3岁以上患儿病毒检出率有下降趋势。 4.通过对四个研究年度呼吸道相关病毒检出及流行情况进行比较,发现如下流行趋势:(1)在前三个研究年度,RSV一直是检出率最高的病毒,HRV居第二位;在本年度HRV跃居为检出率最...
Other AbstractObjective To study the clinical and molecular epidemiology characteristics of related pathogens of acute respiratory tract infections (ARTIs) in children in Lanzhou area from December 2009 to November 2010, focusing on monitoring the human metapneumovirus, human Bocavirus, mycoplasma pneumonia. To accumulation data on the etiology of acute respiratory infection epidemiological study in Lanzhou. To provide the basis for clinical anti-infection treatment.At the same time, We carried out real-time fluorescence quantitative PCR method in the detection of respiratory pathogens. Subjects and Methods 1.Nasopharyngeal aspiration(NPA) samples and throat swabs were collected from 545 children with ARTI at the First Hospital of Lanzhou University,Gansu Province,China,between December 2009 and November 2010. 2.Real-time quantitative RT-PCR was used to detecte human metapneumovirus; Nested PCR was used to detecte human Bocavirus; RT-PCR and standard PCR were employed to screen ten respiratory infection-associated viruses, Including ADV, RSV, IFV (A, B ), HRV , PIV (1-3 ), HCOV-NL63, HCOV-HKUI. Then the amplicons were sequenced and phylogenetic analysis was conducted. Combined with four years of continuous research datas, we analyzed the epidemiological characteristics associated virus 3.Real-time quantitative RT-PCR was used to detecte Mycoplasma pneumoniae in NPA . We analyzed the clinical data of positive patients, to understand the prevalence and epidemiolog of Mycoplasma pneumoniae.Meanwhile, to study the clinical and molecular epidemiology characteristics in Nanjing area with the same method. By comparing datas from the two regions, to preliminary understand the molecular epidemiology differences of Mycoplasma pneumoniae infection of the in eastern and western China. Results 1.In this study, we detected 54 cases of human metapneumovirus-positive specimens, the detection rate was 9.91%,ranking forth in our study viruses. The average viral load of positive samples was 4.88 × 109 copies / ml;The specimens which viral load was more than 106 copies / ml accounted for 72.22%. By genotyping of matrix protein, 21 cases (38.89%) were typed. The results of phylogenetic analysis showed: A2b were the dominant type (47.62%) in the study year. Moreover, A2b type has been the dominant type in the last four years.The detected rate was no signification difference between male and female. The peak detection period was from March to May. Positive cases less than 1 year o...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/224293
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
曹长青. 2009-2010年兰州地区儿童急性呼吸道感染病原学研究[D]. 兰州. 兰州大学,2011.
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