CAJ | 학술논문

目的探讨发热伴血小板减少综合征易被误诊的原因。方法采用间接免疫荧光法检测患者急性期与恢复期血清中新布尼亚病毒IgG抗体，荧光RT- PCR检测新布尼亚病毒RNA及S、M、L 3个特异性基因鉴定，新布尼亚病毒核酸测序及比对分析。结果2例误诊患者的血清中IgG抗体效价恢复期较急性期增高4倍以上，3例患者的急性期血清中均能检测到新布尼亚病毒核酸及3个特异性基因，S基因序列比对均为新布尼亚病毒，重症患者与轻症患者的基因序列有一定的差异。结论通过病毒特异性基因鉴定、序列比对分析以及双份血清新布尼亚病毒IgG抗体效价检测，3例临床误诊的患者均为由新布尼亚病毒感染引起的发热伴血小板减少综合征。
목적탐토발열반혈소판감소종합정역피오진적원인。방법채용간접면역형광법검측환자급성기여회복기혈청중신포니아병독IgG항체，형광RT- PCR검측신포니아병독RNA급S、M、L 3개특이성기인감정，신포니아병독핵산측서급비대분석。결과2례오진환자적혈청중IgG항체효개회복기교급성기증고4배이상，3례환자적급성기혈청중균능검측도신포니아병독핵산급3개특이성기인，S기인서렬비대균위신포니아병독，중증환자여경증환자적기인서렬유일정적차이。결론통과병독특이성기인감정、서렬비대분석이급쌍빈혈청신포니아병독IgG항체효개검측，3례림상오진적환자균위유신포니아병독감염인기적발열반혈소판감소종합정。
Objective To identify the pathogen of misdiagnosed cases of fever with thrombocytopenia syndrome. Methods Blood samples were col ected from 3 misdiagnosed cases of fever with thrombocytopenia syndrome in acute and convalesce phases. The serum levels of virus- specific IgG antibody were detected with indirect immunofluorescence assay, and the viral RNA and three segments L(large), M(medium), and S(smal ) was detected with fluorescent reverse- transcription polymerase chain re-action (RT- PCR) assay. The pathogen was characterized by nucleic acid sequencing and comparative analysis. Results The serum IgG antibody titer in convalesce phase was increased more than 4 times than those of acute phase in 2 misdiagnosed cases. The virus nucleic acid and three specific genes were detected in acute phase serum of 3 cases. S gene sequence alignment was confirmed novel Bunia virus;there were some differences in gene sequences between severe cases and mild cases. Conclusion We confirmed that three misdiagnosed cases of fever with thrombocytopenia syndrome were infected with novel Bunia virus.