小儿急性感染性胃肠炎轮状病毒感染的病原学研究

目的 了解我国广大地区小儿腹泻中轮状病毒感染的情况。方法 从我国有代表性地区收集到1968例腹泻患儿粪便标本、148例无腹泻儿、135例正常新生儿的同样标本，以及36例成年腹泻患者和37例无腹泻成人粪便标本，采用聚丙烯酰胺凝胶电泳（PAGE）查标本中轮状病毒RNA，部分标本同时用ELISA法查轮状病毒抗原，以及电镜检查病毒，部分标本还进行常规细菌培养。所有腹泻患者均符合WHO诊断标准。结果 从1968例腹泻患儿标本中804例查出轮状病毒RNA，病毒RNA阳性率为40．9％。36例成年腹泻患者中1例轮状病毒RNA阳性，其余无腹泻者均未查出轮状病毒RNA阳性。在1968例患儿便标本中，1493例用ELISA法查出33．5％轮状病毒阳性。在804例轮状病毒RNA阳性中，A组轮状病毒阳性占99．6％，C组占0．4％。A组轮状病毒中RNA长型占65．8％，RNA短型占33．3％，其他占0．8％。轮状病毒RNA长、短型中又可各分为4个主要电泳型（4232、4222、3232、3222），病毒基因变化集中在第2、3及7－9片段上。病毒感染有明显季节性，秋冬季感染多，春夏季感染少。从患儿中检出病毒以－1岁、－2岁为高，病毒感染主要集中在2岁以内，尤其是6个月至2岁。在不同地区、城市、年份、轮状病毒感染率不一，可能与当地气候条件等因素有关。此外，还比较不同检测方法对病毒检出率的影响。结论 通过本调查研究表明，我国广大地区小儿腹泻中轮状病毒感染是主要病原，多发于秋冬季和2岁以内的婴幼儿。

Etiological study on human rotavirus infections in children with acute gastroenteritis

OBJECTIVE: To understand the etiology of human rotavirus infections in children with acute gastroenteritis in China. METHODS: The investigation covered 1968 feces infants and children with acute gastroenteritis in 19 provinces and cities in China. Feces samples collected from 1968 infants and children with diarrhea, 148 children, 135 newborns and 37 adults without diarrhea, 36 adults with diarrhea were examined by polyacrylamide gel electrophoresis (PAGE). 1493 feces samples were examined by ELISA; 388 feces samples from sick children and 57 feces samples from children and adults without diarrhea were examined by EM. Bacterial culture were analyzed in 645 feces samples. RESULTS: Human rotavirus RNA (HRV RNA) was detected in 804(40.9%) of 1968 feces samples examined. No virus was detected in the feces samples of children and adults without diarrhea. Rotavirus antigen was detected in 500 (33.5%) of the 1493 feces samples. According to the genome profile of PAGE, 801 (99.6%) of the 804 rotavirus RNA positive belonged to group A virus, and the other 3 (0.4%) belonged to group C virus. According to the different migration of 10 and 11 segments on PAGE, the RNA pattern of group A rotavirus could be subdivided into two patterns: long and short patterns. The 527 (66.8%) positive HRV RNA was in the long pattern, while the 267 (33.3%) positive were in the short pattern. Among the rest 6 appeared to be mixed types, and the examined one was uncertain. Four different genotypes of HRV RNA in long and short patterns were identified respectively. They were types 4232, 4222, 3232 and 3222. The eight electropherotype genomes of HRV RNA varied not only in different years or seasons but also with the ages of patients and regions where the patients live. CONCLUSION: Rotavirus infections are the major cause of diarrhea of infants and young children throughout China.