呼和浩特市婴幼儿星状病毒性肠炎流行特征及临床分析

目的 了解呼和浩特市急性腹泻患儿星状病毒（HAstV）流行病学特征、基因分型和临床特征。方法 采用RT-PCR检测2015年1月-2017年4月因急性腹泻住院患儿粪便标本的星状病毒特异性基因,对结果行统计学分析,随机抽取3份阳性标本的RT-PCR产物行基因分析和分型,同时收集病人临床资料进行分析。结果 收集粪便标本共610份,检出HAstV阳性39份,检出率6.39%,男∶女为1.78∶1;不同月龄组阳性检出率差异有统计学意义（P<0.001）,6-11月龄组检出率最高（7.54%）;不同月份检出率以11月-来年2月检出率高;患儿表现不同程度脱水,电解质紊乱,代谢性酸中毒,部分合并诺如病毒和轮状病毒感染,3例并发良性惊厥,3例ALT轻度升高;PCR得到扩增片段符合预期,与Mamastrovirus-1（ KC342249.1）和Human astrovirus -SH1（FJ375759.1）相似性为98%。结论 HAstV是呼和浩特地区婴幼儿病毒性肠炎的主要病原之一,本次检出株为HAstV1型;不同月龄、不同月份阳性率不同;临床症状较轻微,脏器损害不明显;PCR检测结果有助于星状病毒早期诊断。

Epidemic characteristics and clinical analysis of infant astrovirus enteritis in Hohhot

Objective To investigate the epidemiological, genotyping and clinical features of human astroviruses (HAstV) in children with acute diarrhea in Hohhot. Methods RT-PCR was used to detect astrovirus-specific genes in fecal specimens of children hospitalized with acute diarrhea from January 2015 to April 2017. The results were statistically analyzed, three positive samples were randomly selected for RT-PCR analysis and genotyping and the patient's clinical data was collected for analysis. Results Of the 610 stool samples, 39 were positive for HAstV with the detection rate of 6.39%, and the ratio of male/female was 1.78 (P<0.001); the positive detection rate of different month-old group was statistically significant (P<0.001). The detection rate was the highest (7.54%) in the 6-11 months old group; the difference in detection rates in different months was significant, and the highest detection rate was from Nov. to Feb. the next year; the children showed varying degrees of dehydration, electrolyte disturbances, partial incorporation of norovirus and rotavirus infection, there were three cases concurrent benign convulsions and three cases of mildly elevated ALT. The amplified fragment obtained by PCR met the expectation, which shared most nucleotide identities (98%) to mamastrovirus-1 (GenBank KC342249.1) and human astrovirus-SH1 (GenBank FJ375759.1). Conclusions HAstV is one of the main pathogens causing infantile viral enteritis in Hohhot area, and the prevalent strain is HAstV-1. Different months and different seasons have different positive rates; the clinical symptoms are mild, and the organ damage is not obvious; PCR results can be helpful for the early diagnosis of astrovirus.