中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2014年
9期
766-770
,共5页
考庆君%孙昼%谢立%濮小英%杨旭辉%黄仁杰
攷慶君%孫晝%謝立%濮小英%楊旭輝%黃仁傑
고경군%손주%사립%복소영%양욱휘%황인걸
肝炎,戊型%肝炎病毒,戊型%基因型%流行特征%疾病控制
肝炎,戊型%肝炎病毒,戊型%基因型%流行特徵%疾病控製
간염,무형%간염병독,무형%기인형%류행특정%질병공제
Hepatitis E%Hepatitis E virus%Genotype%Epidemiologic characteristics%Disease control
目的：分析杭州市2004-2011年戊型肝炎（简称戊肝）的流行特点以及戊肝病毒基因分型特点。方法利用中国疾病预防控制信息系统《疾病监测信息报告管理系统》，收集2004-2011年杭州市戊肝的发病情况及患者的基本信息。于2011年在杭州市定点传染病医院，采用随机数字表法选取实验室已确诊的戊肝患者65例，采集其血液标本60份及粪便标本18份；在全市范围内采用随机整群抽样的方法选取杭州市1个城区及2个周边县区，选取该区生猪定点屠宰场及农户作为采样点，采集猪胆囊标本52份，采集散养猪和兔子的粪便分别为30和15份。对标本进行戊肝病毒检测，并进行基因提取和基因序列分析，将测得的核酸序列与GenBank数据库中戊肝病毒毒株的基因序列进行比对，并绘制进化树。对2004-2011年杭州市戊肝发病流行特征进行描述，分析杭州市各年份及性别间戊肝发病率的差异。结果2004-2011年杭州市累计报告戊肝患者3490例，死亡3例，年平均发病率为5.79/10万（3490/60276338）。不同年份间发病率呈上升趋势（χ2＝52.38，P＜0.01），其中2011年最高，为8.10/10万（705/8700373），2005年最低，为4.19/10万（304/7259008）；男性[8.12/10万（2474/30450990）]高于女性[3.46/10万（1016/29384491）]（χ2＝558.45，P＜0.05）。采集确诊患者血液及粪便标本共78份，检出阳性标本16份，阳性率为21％，采集猪胆、猪粪便、兔子粪便标本共97份，检出2份兔子粪便阳性标本，阳性率为2％。杭州市分离的戊肝病毒基因以Ⅳ型为主，同源性为91.8％～100％；与人戊肝病毒Ⅳ型毒株同源性为84.6％～96.7％；与猪分离的戊肝Ⅳ型病毒株同源性为82.6％～95.2％。结论杭州市戊肝发病年呈逐年上升趋势，戊肝病毒基因型以Ⅳ型病毒株为主，在人群中与猪群中存在高度同源性。
目的：分析杭州市2004-2011年戊型肝炎（簡稱戊肝）的流行特點以及戊肝病毒基因分型特點。方法利用中國疾病預防控製信息繫統《疾病鑑測信息報告管理繫統》，收集2004-2011年杭州市戊肝的髮病情況及患者的基本信息。于2011年在杭州市定點傳染病醫院，採用隨機數字錶法選取實驗室已確診的戊肝患者65例，採集其血液標本60份及糞便標本18份；在全市範圍內採用隨機整群抽樣的方法選取杭州市1箇城區及2箇週邊縣區，選取該區生豬定點屠宰場及農戶作為採樣點，採集豬膽囊標本52份，採集散養豬和兔子的糞便分彆為30和15份。對標本進行戊肝病毒檢測，併進行基因提取和基因序列分析，將測得的覈痠序列與GenBank數據庫中戊肝病毒毒株的基因序列進行比對，併繪製進化樹。對2004-2011年杭州市戊肝髮病流行特徵進行描述，分析杭州市各年份及性彆間戊肝髮病率的差異。結果2004-2011年杭州市纍計報告戊肝患者3490例，死亡3例，年平均髮病率為5.79/10萬（3490/60276338）。不同年份間髮病率呈上升趨勢（χ2＝52.38，P＜0.01），其中2011年最高，為8.10/10萬（705/8700373），2005年最低，為4.19/10萬（304/7259008）；男性[8.12/10萬（2474/30450990）]高于女性[3.46/10萬（1016/29384491）]（χ2＝558.45，P＜0.05）。採集確診患者血液及糞便標本共78份，檢齣暘性標本16份，暘性率為21％，採集豬膽、豬糞便、兔子糞便標本共97份，檢齣2份兔子糞便暘性標本，暘性率為2％。杭州市分離的戊肝病毒基因以Ⅳ型為主，同源性為91.8％～100％；與人戊肝病毒Ⅳ型毒株同源性為84.6％～96.7％；與豬分離的戊肝Ⅳ型病毒株同源性為82.6％～95.2％。結論杭州市戊肝髮病年呈逐年上升趨勢，戊肝病毒基因型以Ⅳ型病毒株為主，在人群中與豬群中存在高度同源性。
목적：분석항주시2004-2011년무형간염（간칭무간）적류행특점이급무간병독기인분형특점。방법이용중국질병예방공제신식계통《질병감측신식보고관리계통》，수집2004-2011년항주시무간적발병정황급환자적기본신식。우2011년재항주시정점전염병의원，채용수궤수자표법선취실험실이학진적무간환자65례，채집기혈액표본60빈급분편표본18빈；재전시범위내채용수궤정군추양적방법선취항주시1개성구급2개주변현구，선취해구생저정점도재장급농호작위채양점，채집저담낭표본52빈，채집산양저화토자적분편분별위30화15빈。대표본진행무간병독검측，병진행기인제취화기인서렬분석，장측득적핵산서렬여GenBank수거고중무간병독독주적기인서렬진행비대，병회제진화수。대2004-2011년항주시무간발병류행특정진행묘술，분석항주시각년빈급성별간무간발병솔적차이。결과2004-2011년항주시루계보고무간환자3490례，사망3례，년평균발병솔위5.79/10만（3490/60276338）。불동년빈간발병솔정상승추세（χ2＝52.38，P＜0.01），기중2011년최고，위8.10/10만（705/8700373），2005년최저，위4.19/10만（304/7259008）；남성[8.12/10만（2474/30450990）]고우녀성[3.46/10만（1016/29384491）]（χ2＝558.45，P＜0.05）。채집학진환자혈액급분편표본공78빈，검출양성표본16빈，양성솔위21％，채집저담、저분편、토자분편표본공97빈，검출2빈토자분편양성표본，양성솔위2％。항주시분리적무간병독기인이Ⅳ형위주，동원성위91.8％～100％；여인무간병독Ⅳ형독주동원성위84.6％～96.7％；여저분리적무간Ⅳ형병독주동원성위82.6％～95.2％。결론항주시무간발병년정축년상승추세，무간병독기인형이Ⅳ형병독주위주，재인군중여저군중존재고도동원성。
Objective To comprehend the epidemiologic of hepatitis E and genetic characteristics of hepatitis E virus ( HEV) in Hangzhou from 2004 to 2011.Methods Using China information system for disease control and prevention , the incidence of hepatitis E from 2004 to 2011 in Hangzhou city , and the basic information of patients were collected.In 2011, 65 hepatitis E laboratory confirmed cases were selected by random number table sampling method from the hospitals designated infectious diseases in Hangzhou city , and acquisition of the 60 blood specimens and stool specimens of 18 copies.One city and two surrounding counties were selected by cluster random sampling method in the context of Hangzhou city , and the pig slaughters and farmers were selected as the sampling point , and acquisition of pig gallbladder specimens of 52 copies,and 30 stool samples of scatter-feed pigs, 15 stool specimens of scatter-feed rabbits.HEV was tested in samples , gene extraction and analysis of gene sequence were conducted which were compared with gene bank HEV gene sequence , and a phylogenetic tree was formed.The epidemic characteristics of hepatitis E of Hangzhou city from 2004 to 2011 were described.The difference of incidence of hepatitis E was analyzed between years and sexes in Hangzhou city.Results There were reported a total of 3 490 cases of hepatitis E in Hangzhou from 2004 to 2011, and 3 cases of death;The average annual incidence rate was 5.79/100 000(3 490/60 276 338).There was the overall upward trend in incidence between different years (χ2 =52.38,P<0.01), which the highest was 8.10/100 000(705/8 700 373) in 2011, and the lowest incidence rate was 4.19/100 000 in 2005.The incidence of males ( 8.12/100 000 ( 2 474/30 450 990 ) ) was significantly higher than that of the females (3.46/100 000(1 016/29 384 491)) (χ2 =558.45,P<0.05).78 specimens of blood and stool were collected , including 16 positive samples, with positive rate 21%.There were a total of 97 specimens of pig gallbladder , pig manure and rabbit stool , including 2 positive rabbit stool samples , with positive rate of 2%.HEV genes isolated from Hangzhou were mainly typeⅣ, with homology of 91.8%to 100%; compared with human type Ⅳ strains, the homology of nucleotide was 84.6%-96.7%; compared with type Ⅳ strain of pig genome sequence alignment , homology was 82.6%-95.2%.Conclusion Hepatitis E′s incidence showed an increasing trend year by year in Hangzhou.HEV of type Ⅳ was dominant , and HEV strains in the human and swine were highly homologous.
