CAJ | 학술논문

目的从病例临床特征、抗体变化规律及病原学检测等多角度分析一起由甲型H1N1和H3N2流感病毒混合感染引起暴发疫情的流行特征,为有效控制疾病的发生与蔓延提供科学依据.方法采用回顾性调查和现场流行病学调查方法进行问卷调查,利用RT-PCR和血凝抑制试验分别进行流感病毒和血清抗体检测.结果 45例流感样病例中,确诊40例,其中22例为甲型H1N1流感、12例为季节性H3N2型流感、6例为H1N1和H3N2病毒混合感染.不同病毒感染病例的临床表现差异无统计学意义.序列比对分析显示,混合病毒感染和单一病毒感染者的甲型H1N1和季节性H3N2病毒基因序列没有差异.同时分析表明,所有流感病例的病毒株均对金刚烷胺耐药,对奥司他韦(达菲)有效.患者的双份血清血凝抑制试验检测表明,暴发由甲型H1N1和H3N2流感病毒混合感染引起.结论这是一起由甲型H1N1和H3N2流感病毒混合感染引起的疫情,甲型H1N1病毒在传播过程中可能较H3N2更具有优势.
목적 종병례림상특정、항체변화규률급병원학검측등다각도분석일기유갑형H1N1화H3N2류감병독혼합감염인기폭발역정적류행특정,위유효공제질병적발생여만연제공과학의거.방법 채용회고성조사화현장류행병학조사방법진행문권조사,이용RT-PCR화혈응억제시험분별진행류감병독화혈청항체검측.결과 45례류감양병례중,학진40례,기중22례위갑형H1N1류감、12례위계절성H3N2형류감、6례위H1N1화H3N2병독혼합감염.불동병독감염병례적림상표현차이무통계학의의.서렬비대분석현시,혼합병독감염화단일병독감염자적갑형H1N1화계절성H3N2병독기인서렬몰유차이.동시분석표명,소유류감병례적병독주균대금강완알내약,대오사타위(체비)유효.환자적쌍빈혈청혈응억제시험검측표명,폭발유갑형H1N1화H3N2류감병독혼합감염인기.결론 저시일기유갑형H1N1화H3N2류감병독혼합감염인기적역정,갑형H1N1병독재전파과정중가능교H3N2경구유우세.
Objective To understand the epidemiological characteristics in an outbreak of mixed infection of H1N1 and H3N2 viruses through analysing the clinical features,antibody changes,pathogenic detections and to provide basis for the disease prevention and control measures.Methods Epidemiological and clinical data were collected by in-terviewing patients and retrieving medical records.Viruses were identified by RT-PCR assays followed by sequence analy-sis.Hemagglutination inhibition(HI)test was used to detect antibodies for both viruses.Results In 45 people with influenza-like illness,40 were laboratory-confirmed influenza cases,among which 22 were infected by pandemic H1N1virus,12 by seasonal H3N2 virus,and 6 by both viruses.The clinical manifestations of patients with different virus infection were essentially similar.There was no substantial difference in genomic sequences of either pandemic H1N1 or seasonal H3N2 virus between patients with the mixed and single infection.Sequence analyses revealed that all the detected viruses were oseltamivir-sensitive but adamantane-resistant.HI tests of paired sera confirmed the mixed infection within the outbreak.Conclusions Co-circulation of both viruses lead to a mixed infection influenza pandemic.However,pandemic H1N1 virus is priority in prevalence in the course of transmission.