CAJ | 학술논문

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1 968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～l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。
목적료해아국엄대지구소인복사중륜상병독감염적정황。방법종아국유대표성지구수집도1 968례복사환인분편표본、148례무복사인、135례정상신생인적동양표본，이급36례성년복사환자화37례무복사성인분편표본，채용취병희선알응효전영(PAGE)사표본중륜상병독RNA，부분표본동시용ELISA법사륜상병독항원，이급전경검사병독，부분표본환진행상규세균배양。소유복사환자균부합WHO진단표준。결과종1968례복사환인표본중804례사출륜상병독RNA，병독RNA양성솔위40.9％。36례성년복사환자중1례륜상병독RNA양성，기여무복사자균미사출륜상병독RNA양성。재1968례환인편표본중，1493례용ELISA법사출33.5％륜상병독양성。재804례륜상병독RNA양성중，A조륜상병독양성점99.6％，C조점0.4％。A조륜상병독중RNA장형점65.8％，RNA단형점33.3％，기타점0.8％。륜상병독RNA장、단형중우가각분위4개주요전영형(4232、4222、3232、3222)，병독기인변화집중재제2、3급7～9편단상。병독감염유명현계절성，추동계감염다，춘하계감염소。종환인중검출병독이～l세、～2세위고，병독감염주요집중재2세이내，우기시6개월지2세。재불동지구、성시、년빈，륜상병독감염솔불일，가능여당지기후조건등인소유관。차외，환비교불동검측방법대병독검출솔적영향。결론통과본조사연구표명，아국엄대지구소인복사중륜상병독감염시주요병원，다발우추동계화2세이내적영유인。
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 chil dren 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.