轮状病毒腹泻患儿病毒血症和肠道外脏器感染的研究

目的探讨轮状病毒(RV)腹泻患儿是否会发生病毒血症,以及RV是否能感染肠道外脏器。方法以套式RT-PCR方法检测全部60例RV腹泻患儿的血浆标本和其中14例单个核细胞中的RV基因;以原位杂交和原位RT-PCR方法检测2例伴有RV感染的死亡患儿各脏器中的RV基因。结果从60例患儿中检测到病毒血症4例:1例血浆中检测到RV阳性,其PCR产物部分测序结果证实属RV序列,血清型III,未见变异;14例单个核细胞中检测到3例阳性,其相应的血浆标本RV阴性。从2例死亡患儿的小肠、肝脏、肺、肾脏中检测到RV基因。结论普通RV腹泻患儿可出现病毒血症,RV可以从肠道向其他脏器扩散,病毒血证实其扩散途径。

Viremia and extraintestinal infections in infants with rotavirus diarrhea

Objective To test the hypothesis that viremia might be involved in infants with rotavirus (RV) diarrhea and ex-traintestinal infection. Methods The genomes of RV in the plasma of 60 infants with RV diarrhea were detected with nestedreverse transcriptase-PCR, which were also performed on the mononuclear cells from 14 of these infants showing abnormalmyocardial and hepatic enzyme profiles. The RV genomes in the vital organs of 2 dead infants with RV infection were exam-ined with in situ hybridization and indirect in situ PCR. Results RV viremia was identified in 4 out of the 60 infants, and inone of the 4 cases, RV positive was affirmed in plasma in which RV sequence of serotype Ⅲ without variation was found bypartial sequencing of the PCR product, while the other 3 were found no RV positive mononuclear cells in the plasma samples.The genomes of rotavirus were found in the intestines, liver, lung and kidney of the 2 dead infants. Conclusion RV viremia ispossible in young children requiring medical attention for RV diarrhea, and RV might migrate from intestines to other organsduring viremia.